RESUMO
Background: Microalbuminuria is a marker of widespread vascular damage in diabetic as well as non-diabetic patients. However, more and more evidence is accumulating that microalbuminuria is an important cardiovascular risk factor even in the general population. Its early detection helps in preventing the progression of cardiac decompensation. Aggressive treatment of microalbuminuria is associated with improved renal and cardiac functions. Aim of the study: To find out the prevalence of microalbuminuria in non-diabetic and nonhypertensive patients with coronary artery disease. Materials and methods: Prospective nonrandomized case series was done in the Department of General Medicine, GAAMCH, Karapettai, Kanchipuram in the year 2017. In this 50 non-diabetic and non-hypertensive CAD patients were selected from those admitted in General Medicine ward. Data collection was by clinical history, examination and investigations such as blood investigations- fasting blood sugar, blood urea, serum creatinine, serum electrolytes, fasting lipid profile, urine albumin, and deposits, chest X-ray PA view, ECG, Echo were done and reports were analyzed thoroughly. Results: Among the males, 94.3% were smokers and 5.7% were non-smokers. 100% of women were non-smokers. There were 12 patients with abnormal total cholesterol, out of which 10 patients (83.33%) had microalbuminuria and out of 38 patients (73.68%) with normal total cholesterol, 28 had microalbuminuria. The observation showed that there was no significant association between total cholesterol and microalbuminuria (P>0.05). Namashivayam Shanmugasundram, Raja Ponnusamy. A study of prevalence of microalbuminuria in non-diabetic nonhypertensive coronary artery disease. IAIM, 2019; 6(4): 31-35. Page 32 Conclusion: Among the 50 non-diabetic non-hypertensive CAD patients, 38 patients (76%) had microalbuminuria. Microalbuminuria is positively associated with the ischemic heart disease in nondiabetic non-hypertensive CAD patients and can be regarded as an additional risk factor for ischemic heart disease. Hence screening for microalbuminuria is a worthwhile public tool for cardiac risk stratification and targeting preventive strategies.
RESUMO
Background: Metabolic syndrome is one of the major health issues of this century. It is a constellation of physical conditions and metabolic abnormalities commonly occurring together, that increases the individual's risk for the development of type 2 diabetes mellitus and cardiovascular disease. The aim of the study: To ascertain the prevalence of metabolic syndrome in patients with the acute coronary syndrome and to find out the association of each component of metabolic syndrome with acute coronary syndrome. Materials and methods: Prospective nonrandomized case series was done in the Department of General Medicine, Government Royapettah Hospital, Chennai in the year 2016. About 100 patients admitted to the intensive coronary care unit patients with unstable angina, STEMI and NSTEMI were evaluated for metabolic syndrome using NCEP ATP III guidelines. Waist circumference was measured at the narrowest point with stomach relaxed. Blood samples were collected for fasting blood sugar with overnight fasting. Blood samples were collected for lipid profile with 12 hours overnight fasting. Blood pressure was recorded in right upper limb in sitting posture. Results: Out of 33 patients with metabolic syndrome, all 33 had elevated blood sugar values greater than 100 mgs%. In the non-metabolic syndrome group, 44 patients had elevated blood sugar out of 67 patients. Blood pressure was elevated more than the cut off value in 26 patients out of 33 patients with metabolic syndrome.17 patients out 67 had elevated blood pressure in patients without metabolic syndrome. Waist circumference was increased in 22 out of 33 patients with metabolic syndrome when compared to 60 out of 67 in patients without metabolic syndrome. Waist circumference in patients Raja Ponnusamy, Namashivayam Shanmugasundram. A study of prevalence of metabolic syndrome in patients with acute coronary syndrome. IAIM, 2019; 6(4): 14-19. Page 15 with metabolic syndrome was 66% when compared to 89% in patients without metabolic syndrome. p-value was significant and was less than 0.001. Out of the 100 patients 21 patients had elevated triglyceride levels among 33 patients with metabolic syndrome and 8 patients with no metabolic syndrome among 67 patients. The difference between the two groups was 63%versus 13%. Conclusion: Metabolic syndrome is associated with higher risk characteristics and increased risk for the development of heart failure without increase in-hospital mortality. So to prevent the complications due to metabolic syndrome there is a need for early and intensive preventive measures.