ABSTRACT
OBJECTIVES: To identify patients who are at risk for a first cardiovascular event, mitigate the risk, and institute early intervention. The triglyceride to high-density lipoprotein-C (TG/HDL-C) ratio has been found to be a very useful biomarker for directing treatment and prevention therapy. METHODS: This retrospective cross-sectional study included adult patients (aged >18 years) experiencing first-time acute coronary syndrome (ACS). We examined all patient databases for a definite diagnosis of angina, non-ST segment elevation myocardial infarction (NSTEMI), or ST-segment elevation myocardial infarction (STEMI). Lipid profiles were obtained prior to or at the time of admission. RESULTS: A total of 265 patients were included in the study (mean age 57.83 ± 11.4 years) and 79.2% were men. Male gender, presence of diabetes, raised total cholesterol, raised low-density lipoprotein (LDL), and raised troponin level on admission were significantly positively correlated with STEMI (p=0.004, p=0.001, p<0.001, and p<0.001), whereas TG/HDL-C ratio was significantly negatively correlated with STEMI (p=0.048), while there was no significant results with NSTEMI (p=0.264) and angina (p=0.326). Total cholesterol and raised low-density lipoprotein (LDL) were significantly positively correlated with NSTEMI (p=0.013 and p=0.024). CONCLUSION: Patients with first-time ACS may not have an increased TG/HDL-C ratio. High LDL levels had the most significant association with an ACS event, along with total cholesterol and diabetes. Further research is needed on a larger scale to determine the association of TG/HDL-C ratio with ACS and differentiate the different types of ACS events according to their clinical and laboratory characteristics.
Subject(s)
Acute Coronary Syndrome , Myocardial Infarction , Non-ST Elevated Myocardial Infarction , ST Elevation Myocardial Infarction , Adult , Humans , Male , Middle Aged , Aged , Female , Lipoproteins, HDL , Triglycerides , Acute Coronary Syndrome/diagnosis , ST Elevation Myocardial Infarction/diagnosis , Non-ST Elevated Myocardial Infarction/diagnosis , Retrospective Studies , Cross-Sectional Studies , Risk Factors , Cholesterol , Lipoproteins, LDL , Cholesterol, HDLABSTRACT
OBJECTIVES: To assess the readiness of hospitals in Riyadh to establish acute stroke centers by following the Australian Clinical Guidelines for Stroke Management. METHODS: This study was a quantitative cross-sectional observational study conducted among hospitals in the central region of Saudi Arabia (Jan 2018 - April 2018). A self-administered questionnaire/survey tool was adapted from an Australian survey developed by the Stroke Foundation in Melbourne, Australia.The data were analyzed using SPSS version 21.0. Appropriate statistical tests (chi-square and Fisher's exact test) were used for bivariate analyses. RESULTS: A total of 3932 stroke patient visits were recorded in 37 hospitals in the central region of Saudi Arabia. The most common limitations of acute stroke services were that 25 (67.57%) of the hospitals had no stroke unit and 21 (56.76%) had inadequate clinical staff. Magnetic resonance imaging and computed tomography were available in 32 (86.49%) and 36 (97.30%) hospitals, respectively. Only two-thirds of hospitals 25 (67.57%) followed protocols for rapid Emergency Department (ED) triage. CONCLUSION: We found that most of our hospitals were not fully prepared to address acute stroke management in a manner that was reasonably consistent with international guidelines. We recommend raising the hospital's requirements a higher level to be in line with the stroke guidelines.
