COMPARATIVE STUDY OF LIPID PROFILE OF SMOKERS AND NON-SMOKERS PRESENTING WITH ACUTE CORONARY SYNDROME

Dr. Pramod B. Narkhede; Dr. Anuja Muley; Dr. Pawar Shubhadarshini G.

Volume : VIII, Issue : I, January - 2019

COMPARATIVE STUDY OF LIPID PROFILE OF SMOKERS AND NON-SMOKERS PRESENTING WITH ACUTE CORONARY SYNDROME

Dr. Pramod B. Narkhede, Dr. Anuja Muley, Dr. Pawar Shubhadarshini G.

Abstract :

Introduction: Objectives of the study are to study the lipid profiles in young smokers and non–smokers presenting with first onset of acute coronary syndrome and their comparison and study the effect of smoking on the presentation and outcome of acute coronary syndrome and, to study the effect of lipid profile on the presentation and outcome of acute coronary syndrome.

Methodology– This is prospective case–control study. All data collected was compared between three groups– non–smokers, ex–smoker, current–smokers. studied these young men with no previous history of heart disease or co–morbid condition between age 20–40 years and were screened. Their physical activity, smoking habits, presenting symptoms, vitals, history of microalbuminuria, changes in the electrocardiogram (ECG), ST segment deviation, serum lipids, troponin I values, fasting lipid profile, total blood count, serum electrolytes, Echocardiographic and angiographic evaluation and clinical outcome was recorded and analysed. Various statistical tests such as chi square test, p values, ANNOVA test, t–test were performed using SPSS software.

Result– Incidence of dyslipidaemia was found to be more in patients with sedentary physical activity and was lowest in those with heavy physical activity. 50% of patients with NSTEMI were non–smokers and almost all patients with STEMI were either ex–smokers or current smokers, though >3/4th patients were current smokers. In ex–smokers and current smokers, presence of occlusive disease was more common with angiogram showing SVD / DVD / TVD in majority of patients, indicating more severe disease. Almost all deaths occurred in patients with TVD. Dyslipidaemia (elevated TC, TG & LDL and reduced HDL) was seen more in current smokers compared to ex–smokers and non–smokers. Current smoker group had a greater number of patients with low ejection fraction as compared to non–smoker group. Highest mortality was seen in current smokers.

Conclusion– Incidence of incidence of ACS increases with age and is more in current–smokers than in non–smokers. Morbidity and mortality were seen to be directly related to age, years of smoking, total cholesterol, LDL– cholesterol, total cholesterol / HDL ratio, troponin I elevation, STEMI, conduction defect, amount of ST segment deviation, and extent of CAD. Employment of organized programs and aggressive steps are needed for mass education and awareness regarding smoking and smoking related risk to health. Smoking cessation activities should be encouraged