Jawaharlal Nehru Medical College, Belagavi.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Coronary artery disease (CAD) is one of the commonest heart diseases, accounting for 5-8% global prevalence. Recent studies show a prevalence of 1.2% of CAD cases in young age group. When ethnicity is considered south Asians especially Indians are more vulnerable to have CAD in young age group with a prevalence of 5% to 10%. Predictable risk factors such as smoking, diabetes, hypertension, obesity and family history seems to be as important as in older CAD subjects. But the prevalence of these risk factors seems to vary in younger subjects. Smoking is by far the most commonly associated risk factor in young CAD. Angiographic studies shows predominance of single vessel disease in young CAD patients. Like CAD in older person primary and secondary prevention plays an important role in prevention of new and further coronary events. This global data warrants the need for new screening tools and treatment interventions to reduce the incidence/ prevalence of atherothrombotic disease.
A hospital-based cross-sectional study was conducted on patients between the age group of 18-49 years, admitted in the ICCU fulfilling the inclusion criteria. All the patients who had undergone coronary angiography and satisfying the inclusion criteria were recruited. A total of 104 patients were enrolled. Investigations like complete hemogram, fasting lipid profile (FLP), ECG, ECHO and angiography reports were carried out and results of coronary angiography were noted. Correlations of SVD, DVD, TVD, lipoprotein(a) levels, lipid profiles- total cholesterol, TGL, HDL, LDL were carried out.
The present study suggests the need for routine estimation of Lp(a) in the diagnosis of CAD, which helps in early detection of myocardial damage and timely intervention leading to lowered morbidity and mortality.
本研究旨在探讨冠心病患者血清脂蛋白(a)与冠状动脉病变严重程度的相关性。
选取我院心内科住院的年龄 18-49 岁的冠心病患者 104 例,所有患者均行冠状动脉造影术,记录患者的一般临床资料、冠状动脉造影结果、血脂水平及脂蛋白(a)等,分析血清脂蛋白(a)与冠状动脉病变严重程度的相关性。
1)本研究中,70 例(67.31%)患者的脂蛋白(a)水平升高,34 例(32.69%)患者的脂蛋白(a)水平正常。2)与脂蛋白(a)水平正常的患者相比,脂蛋白(a)水平升高的患者中 LDL 水平相对较低或正常,提示脂蛋白(a)水平对 LDL 分析对 CAD 的重要性。3)高脂蛋白(a)血症患者中,LAD 病变为主,且合并糖尿病的患者脂蛋白(a)水平更高。4)与 STEMI、NSTEMI 和不稳定型心绞痛患者的脂蛋白(a)水平进行比较,发现 43 例患者发生 STEMI,41 例发生 NSTEMI,20 例发生不稳定型心绞痛。5)与脂蛋白(a)水平正常的患者相比,脂蛋白(a)水平升高的患者中 LDL 水平相对较低或正常,提示脂蛋白(a)水平对 LDL 分析对 CAD 的重要性。
本研究提示我们,在诊断 CAD 时需要常规检测脂蛋白(a),这有助于早期发现心肌损伤并及时干预,从而降低发病率和死亡率。