Conclusion

A: Along with high LDL, Low HDL is also considered as a major risk factor for Acute Coronary Syndrome.

B: 67% of patients of ACS have HDL below desired level. While 35% of Patients have  Isolated Low HDL as the only risk factor . Only 5% of patients are seen in which isolated high LDL was considered as single risk factor. So in our conclusion, we will say decrease HDL level is probably more important as compared to high LDL in Asian patients of ACS, and it is often overlooked.Thus while controlling hyperlipidemia, not only LDL, but HDL should also be within normal limits.

C: All the parameters except serum HDL level showed significant increase in obese persons while HDL level was significantly decreased.

D: In our study Age wise comparison revealed that level of total cholesterol; triglyceride and LDL-C were elevating while the level of HDL-C were decreasing with the age in patients of ACS. Sex wise comparison showed that females had higher HDL-C level than males.

E: Patients with Low HDL and high LDL has also more incidence of other risk factors like Hypertension, Smoking and Diabetes.

References
1 Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High-density lipoprotein as a protective factor against coronary heart disease: the Framingham Study. Am J Med.. 1977;62:707–714.

2 Castelli WP, Doyle JT, Gordon T, Hames CG, Hjortland MC, Hulley SB, Kagan A, Zukel WJ. HDL cholesterol and other lipids in coronary heart disease: the Cooperative Lipoprotein Phenotyping Study. Circulation.. 1977;55:767–772.

3 Abbott RD, Wilson PW, Kannel WB, Castelli WP. High density lipoprotein cholesterol, total cholesterol screening, and myocardial infarction: the Framingham Study. Arteriosclerosis. 1988;8:207–211.

4 Wilson PW, Abbott RD, Castelli WP. High density lipoprotein cholesterol and mortality: the Framingham Heart Study. Arteriosclerosis. 1988;8:737–741.

5 Gordon DJ, Probstfield JL, Garrison RJ, Neaton JD, Castelli WP, Knoke JD, Jacobs DR Jr, Bangdiwala S, Tyroler HA. High-density lipoprotein cholesterol and cardiovascular disease: four prospective American studies. Circulation. 1989;79:8–15.

6 Schaefer EJ, Moussa PB, Wilson PW, McGee D, Dallal G, Castelli WP. Plasma lipoproteins in healthy octogenarians: lack of reduced high density lipoprotein cholesterol levels: results from the Framingham Heart Study. Metabolism. 1989;38:293–296.

7 Wilson PW. High-density lipoprotein, low-density lipoprotein, and coronary artery disease. Am J Cardiol. 1990;66:7A–10A.

8 Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA.. 1993;269:3015–3023.

9 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, National Cholesterol Education Program. Second report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation.. 1994;89:1329–1445.

10- Ballantyne CM, Olsson AG, Cook TJ, Mercuri MF, Pedersen TR, Kjekshus J. ,  Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S.Circulation. 2001 Dec 18;104(25):3046-51.

11- Azizi F, Raiszadeh F, Salehi P, Rahmani M, Emami H, Ghanbarian A, Hajipour R. Related Articles, Links  Determinants of serum HDL-C level in a Tehran urban population: the Tehran Lipid and Glucose Study.Nutr Metab Cardiovasc Dis. 2002 Apr;12(2):80-9. PMID: 12189907  

12- Tauheed S, Shoaib S, ul Haque MN, Levels of non-high density lipoprotein cholesterol (non-HDL-C) in patients with ischaemic heart disease.J Ayub Med Coll Abbottabad. 2003 Jan-Mar;15(1):33-4. PMID: 12870314

13- Jafar, TH. Women in Pakistan have a greater burden of clinical cardiovascular risk factors than men. Int. J Cardiol;106 (2006):348-354

14-Pagana KD, Pagana TJ. Mosby’s Manual of Diagnostic and Laboratory Tests. 3rd ed. St. Louis, MO: Mosby/Elsevier; 2006.

15-Lopez AD. Assessing the burden of mortality from cardiovascular diseases. World Health Stat Q 1993;46:91-6.

16 Jha P, Enas EA, Yusuf S. Coronary artery disease in Asian Indians: prevalence and risk factors. Asian Am Pac Islander J Health 1993;1:161-75.

17 Enas EA, Yusuf S, Mehta J. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol 1992;70:945-9

18-Murray CJL, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997; 349: 1269–1276.

19-Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998; 97: 596–601.

20-Wu Z, Yao C, Zhao D, et al. Sino-MONICA project: a collaborative study on trends and determinants in cardiovascular diseases in China, I: morbidity and mortality monitoring. Circulation. 2001; 103: 462–468.

21-Popkin BM, Horton S, Kim S, et al. Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: the economic costs of the nutrition transition. Nutr Rev. 2001; 59: 379–390.

22-Yusuf S, Reddy S, Ounpuu S, et al. Global burden of cardiovascular diseases, I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001; 104: 2746–2753.

<< Previous    1...   15  16  [17]  18  19  ...21    Next >>