Assessment of Serum Fasting Lipid Profile in Diabetic Patients with Acute Coronary Syndrome

Acute Coronary Syndrome (ACS) represents the most severe form of ischemic heart disease. It is a leading cause of cardiovascular-related morbidity and mortality. Diabetic patients have 2 to 3 times increased risk of coronary artery disease as compared to the non-diabetic. The causes for it are multiple, which include dyslipidemia, hypertension and obesity. Dyslipidemia is one of the most common complications of diabetes mellitus. It is known to predispose to premature atherosclerosis and macrovascular complications. Common lipid abnormalities in diabetes are raised triglycerides, raised serum LDL, raised serum cholesterol and low serum HDL. It confers much of accelerated and increased early risk of coronary artery disease. The aim of this study was to assess the fasting lipid profile status in diabetic patients with acute coronary syndrome. This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from July 2018 to June 2019. Total study subjects were ninety-five of both genders selected from the admitted patients of the cardiology department of the National Institute of Cardiovascular Diseases (NICVD), Dhaka. Diagnosis of acute coronary syndrome was confirmed by cardiologist. Diagnosis of diabetes mellitus was confirmed by Fasting Plasma Glucose & HbA1c level. Study subjects were grouped, acute coronary syndrome with diabetes mellitus as Group A and acute coronary syndrome without diabetes mellitus as Group B. Baseline parameters was recorded in data collection sheet. HbA1c, Troponin-I level, fasting plasma glucose and fasting lipid profile of all study subjects were analyzed and recorded. Mean age of the study subjects in Group A and Group B were 51.06 years and 51.66 years respectively. Male gender was predominant in both groups. Mean HbA1c level of the study subjects in Group A was significantly higher than Group B (p=0.001). Mean Troponin-I level in Group A was also significantly higher than Group B (p=0.023). In respect to the components of lipid profile, we found mean ± SD, of TC (172.30 ± 38.10) mg/dl, TG (177.82 ± 57.41) mg/dl, LDL-C (115.10 ± 24.33) mg/dl, HDL-C (34.42 ± 3.72) mg/dl in group A and the mean ± SD of TC (155.20 ± 32.60) mg/dl, TG (114.22 ± 40.86) mg/dl, LDL-C (83.06 ± 16.41) mg/dl, HDL-C (36.78 ± 6.56) mg/dl in group B. All the components of lipid profile showed significant abnormality between the group like that, serum TC, TG, LDL-C were significantly higher (p<0.001) and serum HDL-C significantly lower (p<0.001) in group A than group B. The present study demonstrated significant abnormality of fasting lipid profile in diabetic patients with acute coronary syndrome.