Total Cholesterol and High Density Lipoprotein Cholesterol in Myocardial Infarction Patients and Controls.

Abstract

INTRODUCTION:
Atherosclerotic Coronary heart disease has reached epidemic proportions in ‘the developed countries of the Western world where mortality from it is approximately 1000 per 100,000 population (1). The prevalence of the disease in the tropical countries including Pakistan was thought to be low (2,3,4). However, the hospital admissions from Coronary Heart Disease, appear to have increased dramatically over the past few decades (5,6); even more disconcerting is the relatively high proportion of young individuals, less than forty years of age, afflicted by the disease.

METHODS:

All patients who presented to the Coronary Care unit of Khyber Hospital Peshawar and who were diagnosed as having Myocardial Infarction were included in the study. The diagnosis of Myocardial Infarction was made the basis of at least two of the following Criteria: 1) the presence of typical constricting chest pain, at least half an hour in duration. 2) Elevation of serum Enzymes CPK, SGOT LDH 3) Typical EGG changes of Acute Myocardial Infarction Q waves, QS complex and ST and T wave changes. Cigarette smoking and other forms of tobacco use were also looked at in the control and patient population.

RESULTS:
Age: The mean age of the patient group was 53.9 ± 10.3 years: of the total number of 82 cases there Were ten (12.2%) aged 40 years OR less: 54 (65.8%) in the 41 - 60 years age group and 18 (22%) in the over sixty group. As is apparent from figure 1 the age distribution is similar to other reported series where the majority y of patients falls in the middle aged category (7). Also fairly significant proportions fall in the less than 40 years bracket.

DISCUSSION:
p
A review of available hospital admission data indicates that the number of admissions from CAD is increasing (5,6). No clear reason has emerged from the limited number of studies. Total cholesterol of 206 mgs% in the patient group and 209 mgs% in the present study would rule against this being a significant contributory factor.