Lipid profile in patients with coronary artery disease

OBJECTIVE: To determine the lipid profile and to identify and stratify risk factors in diabetic and non-diabetic patients with proven coronary artery disease at King Hussein Medical Center, Amman, Jordan.

METHODS: One hundred and ninety-two patients who were admitted to Queen Alia Heart Institute, Amman, Jordan, proving to have coronary artery disease (CAD) by angiogram, with a mean age of 54 ± 22 years were studied. Seventy-seven patients were diabetics and 115 non-diabetics. Their lipid profiles (T-Cholesterol, high density lipoprotein level (HDL-C), low density lipoprotein level (LDL-C), triglyceride, glucose, glycosylated hemoglobin) and thyroid function test were compared to a control group of 162 individuals with no cardiac events or diabetes, mean age 48.9 ± 18 years. Prevalence of hyperlipidemia was calculated. Patients with high thyroid stimulating hormone were excluded.

RESULTS: The mean (±standard deviation) plasma cholesterol for the group with CAD is 231.43 ± 57.99 mg/dl versus 202.8 ± 36.58 in the control group (p<0.0003). High density lipoprotein 35.98 ± 9.37 versus 44.43 ± 8.34 (p=0.00011). Low density lipoprotein 146.75 ± 50.93 versus 118.97 ± 45.9 (p=0.003). Triglyceride level 246.95 ± 142.1 versus 164 mg/l ± 93.78 (p=0.0002). Thyroid stimulating hormone level was 1.55 ± 0.9 versus 1.51 ± 0.89 ng/l in control group (p=0.35 NS), HbA1c in diabetic group 7 ± 2.3%. The prevalence of high plasma cholesterol, triglycerides (TG), LDL-C and low HDL-C was 60.9%, 68.3%, 63.5% and 48.4%. Inter-group comparison of patients with CAD (diabetics versus non-diabetics) revealed higher TG level in the diabetic group and statistically significant difference of the HDL and LDL levels between the 2 groups in favor of diabetic group explained by higher percentage of patients on anti-hyperlipidemic drugs than non-diabetics. More females with CAD were found in the diabetic group versus non-diabetic group (16.9% versus 6.1%. z=2.4027 p=0.00820).

CONCLUSION: Jordanian patients with CAD have higher cholesterol, LDL-C, Triglyceride and lower HDL-C levels than the control group which comes in accordance of other studies. Hyperlipidemia remains the strongest risk factor for CAD. Diabetic females are at higher risk for CAD versus non-diabetics with the same lipid profile. Aggressive treatment of hyperlipidemia is of paramount importance to reduce the morbidity and mortality of cardiac events in diabetic and non-diabetic patients.