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TITLE:

LOW-DENSITY LIPOPROTEIN AND SERUM HIGH SENSITIVE C- REACTIVE PROTEIN IN SERUM AS DIAGNOSTIC MARKERS OF ACUTE CORONARY SYNDROME

AUTHORS:

Dr Jawairia Yasin., Dr Amna Shafiq., Dr Muneeba Bint-E-Saeed

ABSTRACT:

Background: Acute coronary syndrome (ACS) remains the leading cause of mortality and morbidity worldwide. The level of lipoproteins and low-density cholesterol (LDL-C) is a major risk factor for the development of ACS and the pathogenesis of atherosclerosis. Atherosclerosis is a multi-stage disease characterized by low-grade chronic vascular inflammation that plays a role at every stage from onset, progression to plaque rupture, and then triggers ACS. Increasing the level of the highly sensitive C-reactive protein (hs-CRP) is a strong and independent prognostic factor for cardiovascular diseases. Aim: The aim of the study was to evaluate the role of LDL-C and hs-CRP in the serum of patients with ACS. Place and Duration: In the cardiology department of Sir Ganagaram Hospital Lahore for one-year duration from August 2019 to August 2020. Patients and Method: The present study enrolled 45 patients with confirmed ACS and 30 apparently healthy people of the same age and gender as controls. The patients were divided into three subgroups, each of which included 15 patients: Subgroup A: STEMI (STEMI). Subgroup B: Non-ST segment elevation myocardial infarction (NSTEMI), Subgroup C: Unstable angina (UAP). All patients and controls were measured for low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides, highly sensitive CRP (hs-CRP), cardiac troponin I (cTnI) and creatine kinase-MB fraction (CK-MB), electrocardiography (EKG) and transthoracic echocardiography. Results: In group I there was a very significant increase in the concentration of LDL-C and hs-CRP in the serum compared to group II (p = 0.001) and a significant increase in the concentration of LDL-C in the serum ((p <0.05) and a very significant increase in hs-CRP concentration (P = 0.01) in the STEMI and NSTEMI subgroups compared to the UAP subgroup and a very significant increase in serum LDL-C (p = 0.005) and serum hs-CRP (p = 0.003) in the UAP subgroup compared to group II. In all subgroups, a positive and significant correlation was also found between serum LDL-C level and both serum CK-MB and serum hsCRP. Conclusion: Elevated serum levels of LDL and hs-CRP may serve as markers of disease severity, which helps in the assessment and treatment of patients with ACS. Keywords: Acute coronary syndrome - lipid profile - Hs-CRP.

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