Clinical profile, risk factors and outcome of ischemic heart disease patients at tertiary care centre

Jignesh F. Vasava, Vaishali G. Patel


Background: Coronary heart disease is responsible for more deaths and disability in developed world, now affecting developing countries. The present study aims to evaluate clinical course, identification of risk factors and outcome of unstable angina.

Methods: An observational study of 30 days follow up of 100 patients of newly diagnosed UA was conducted. Sociodemographic, clinical, family h/o risk factors, dietary, other lifestyle characteristics, Standard 12 lead ECG and BP recorded. Blood was collected for routine investigations and cardiac enzymes (serum Trop-T Quantitative and CPK-MB levels). Blood was Collected in fasting state (glucose and lipid profile) and after4 hrs of routine lunch for Triglyceride measurement. Patients were observed for complications after hospital discharge on OPD basis.

Results: Middle aged patients are more likely to be selected for study (mean age 51.2±6.4) being M:F ratio of 1.5:1. Amongst males 82%were smokers. 68 patients were having Postprandial triglyceride >160 mg% while 58 had low HDL levels(<40mg%).Amongst 100 patients, 68% and 62% found to be Diabetic and hypertensive respectively. Hospital outcome was good.81.2% patients remained free of cardiac events during 30 days follow up while 13.7% admitted with recurrent angina. No mortality during entire study period.

Conclusions: Ischemic heart disease entails high socioeconomic burden due to increased morbidity and mortality. smoking, hypertension, diabetes mellitus and dyslipidemia are important cardiovascular risk factors in present study. Postprandial hypertriglyceridemia was found to be strongly associated with Diabetes Mellitus. Postprandial hypertriglyceridemia despite normal fasting triglyceride may be independent risk factor for atherosclerosis subsequently ischemic heart disease. Early identification, treatment and prevention of cardiovascular risk factors can decline the incidence, complications and related mortality.


Cardiovascular risk factors, Diabetes Mellitus, Dyslipidemia, Ischemic heart disease

Full Text:



Kasper, Fauci, Hauser, Longo. Harrison’s principles of internal medicine, 19th ed. McGraw Hill Education;2016:1439.

Zipes, Libby, Bonow, Mann, Braunwald’s heart disease, 11th edition. Elsevier;2018:2982-83.

Uiterwaal CS, Grobbee DE, Witteman JC, van Stiphout WA, Krauss XH, Havekes LM, de Bruijn AM, van Tol A, Hofman A. Postprandial triglyceride response in young adult men and familial risk for coronary atherosclerosis. Ann Internal Med. 1994;121(8):576-83.

Iso H, Naito Y, Sato S, Kitamura A, Okamura T, Sankai T, et al. Serum triglycerides and risk of coronary heart disease among Japanese men and women. Am J Epidemiol. 2001;153(5):490-9.

Msadiok, Mala D, Prasanna Kumar KM. Prevalence of type 2 diabetes in India (PODIS) by Indian task force on diabetes. 2001.

Elliot TG, Viberti G. Relationship between insulin resistance and the risk of CVD/CAD In diabetes mellitus and general population. Ballieres din Endocrine Metab. 1993;7(4):1063-79.

Syvänne M, Taskinen MR. Lipids and lipoproteins as coronary risk factors in non-insulin-dependent diabetes mellitus. Lancet. 1997;350:S20-3.

Eliasson B, Mero N, Taskinen MR, Smith U. The insulin resistance syndrome and postprandial lipid intolerance in smokers. Atherosclerosis. 1997;129(1):79-88.

Anderson RA, Evans ML, Ellis GR, Graham J, Morris K, Jackson SK, et al. The relationships between post-prandial lipaemia, endothelial function and oxidative stress in healthy individuals and patients with type 2 diabetes. Atherosclerosis. 2001;154(2):475-83.

Bae JH, Bassenge E, Kim KB, Kim YN, Kim KS, Lee HJ, et al. Postprandial hypertriglyceridemia impairs endothelial function by enhanced oxidant stress. Atherosclerosis. 2001;155(2):517-23.

Cohn JS, McNamara JR, Cohn SD, Ordovas JM, Schaefer EJ. Plasma apolipoprotein changes in the triglyceride-rich lipoprotein fraction of human subjects fed a fat-rich meal. J Lipid Res. 1988;29(7):925-36.

Nordestgaard BG, Benn M, Schnohr P, Tybjærg-Hansen A. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA. 2007;298(3):299-308.

Axelton AM. Plasma triglyceride and coronary heart disease. Arteriosclerosis Thrombos J Vascular Biol. 1991;11(1):2-14.

Teno S, Uto Y, Nagashima H, Endoh Y, Iwamoto Y, Omori Y, et al. Association of postprandial hypertriglyceridemia and carotid intima-media thickness in patients with type 2 diabetes. Diabetes Care. 2000;23(9):1401-6.

Manninen V, Elo MO, Frick MH, Haapa K, Heinonen OP, Heinsalmi P, et al. Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki Heart Study. JAMA. 1988;260(5):641-51.

American council on science and Health. Cigarretes: what the warning label doesn’t tell you. Second edition, New York, American council on Science and Health, 2003.

U. S Department of Health and Human Services. The health consequences of smoking. what it means to you. Centre for disease control and prevention. National centre for chronic disease prevention and health promotion, 2004.

Diono FV, Araujo FV, S Oares R. Unstable angina: Individualized stratification and prognosis. Portuguese J Cardiol. 2000;19(5):567-78.