Effect of dyslipidemia and its association with coronary artery disease on angiographic findings

Abstract

Introduction: Dyslipidemia is an abnormal amount of lipids in the blood which act as a most common risk factor for CAD. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood. This is often due to diet and lifestyle. Prolonged elevation of insulin levels can also lead to dyslipidemia. Objective: To assess the effect of dyslipidemia and its association with coronary artery disease on angiographic findings. Methods: This was a retrospective cross-sectional study was carried out at Cardiology Department, Bangladesh Medical College Hospital, Dhaka, Bangladesh from January to December 2021. Information was gathered from medical records of patients admitted for coronary angiography in our Hospital. During the study period 112 consecutive patients, suffering from CAD were examined. Coronary angiography was performed in the catheterization laboratory of the institute and interpreted by interventionist cardiologists. Reporting was done regarding the stenosis percentage of the main epicardial coronary arteries, and the extent of CAD was categorized as one-vessel, two-vessel, or three-vessel disease, according to the number of affected vessels. Statistical analysis was performed with SPSS version 20 (SPSS, Inc., Chicago, IL, USA) statistical software. Results: During the study period, we identified 112 patients who were subjected to coronary angiography.  The mean age of patients were 54.40 years (±SD 8.78 years), where the minimum age was 28 and maximum age was 75. Majority of the patients were young, with around 40.1% (45) of the patients age 46-55 years. The study consisted predominantly of males as represented by 84.82% of the patients, while 15.17% were females. The lipid profile analysis revealed that the mean total cholesterol was 182.60 ± 54.41 mg/dl, mean low-density lipoprotein cholesterol (LDL-C) was 105.46 ± 40.85 mg/dl, mean high density lipoprotein cholesterol (HDL-C) was low, 34.26 ± 7.234 mg/dl and mean triglyceride level was high, 207.64 ± 151.20 mg/dl. The mean levels of different lipids. the patients where dyslipidemia were present in 75.89% patients. Distribution of types of myocardial infarction among the patients. Among 112 patients there were patients of inferior MI 33%, anterior MI 22%, extensive anterior MI 10%, anteroseptal MI 18.5%, Inferolateral MI 9%, lateral MI 4%, high lateral MI 2% and anteroinferior 1.5%. In patients according to clinical findings where mean ± SD of systolic blood pressure was found 134.75 ± 19.25 and random blood sugar was found in 223.81 ± 72.18 mg/dl as well as gallop rhythm was found in 11% patients, those are remarkable. In this study, the most frequent form of dyslipidemia among the patients with significant CAD was found to be low levels of HDL-C (<40mg/dL) at 86.3%, followed by high TG levels (≥150mg/dL) to be 63.2%, high levels of total cholesterol (≥200mg/dl) at 31.6%, and high LDL-C (≥130mg/dL) to be 27.4%. In hospital stay of the patients where mean ± SD of hospital stay of the study patients was 6±0.88 days. 57.1% patients got improved with better outcome and discharged after treatment.