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.
Material: 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.
Observation: 1) Majority of study population 70 (67.31%) had higher level of Lp(a) and 34 (32.69%) had normal Lp(a) level. 2) LDL was comparatively normal or low in patients with High Lp(a) showing the significance of Lp(a) over LDL analysis for CAD. 3) Subjects with high Lp(a) had SVD with LAD predominant and Diabetics had higher Lp(a) values. 4) A comparison of Lp(a) with subject's presentation in the form of STEMI, NSTEMI and Unstable Angina was studied and it was observed that 43 subjects had STEMI, 41 has NSTEMI and 20 had presented with Unstable Angina. 5) LDL was comparatively normal or low in patients with High Lp(a) showing the significance of Lp(a) over LDL analysis for CAD.
Conclusion: 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.
© Journal of the Association of Physicians of India 2011.