CORRELATION OF LIPID PROFILE WITH CAROTID INTIMA MEDIA THICKNESS IN NEWLY DIAGNOSED CORONARY ARTERY DISEASE PATIENTS

Dr. Javeed Ashfaque 1 and Dr. Prakrithi M. D 2 . 1. Department of Medicine, Yenepoya Medical College Hospital. 2. Asst. Professor, Department of Medicine, Yenepoya Medical College Hospital. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History


• Samia Perwaiz et al conducted a study in 2008 on the variations in Carotid intima media thickness in familial
Hypercholesterolemia patients and its use as predictive marker for premature cardiovascular disease. In this study CIMT was found to be significantly increased in familial Hypercholesterolemia and it correlated with raised LDL-cholesterol. Both were predictors of premature cardiovascular disease. • Debalina Sengupta et al conducted a study in 2014 on correlation between lipid profile and carotid intima media thickness in cerebral ischaemia and concluded that the altered lipid profile is associated with cerebral ischaemia by increasing carotid intima media thickness (IMT) . • Preetha et al conducted a study on lipid profile and carotid intima thickness in diabetic and non diabetic ischaemic stroke patients in 2017 and concluded that the lipid parameters including TC ,TG,LDL and VLDL were significantly raised in diabetic stroke patients and had positive correlation with the risk of stroke.  The present study will be carried out after obtaining the Ethical committee clearance. Relevant clinical data (demographic-age, sex, place, occupation) including history will be obtained from patients and detailed clinical examination will be performed.  The risk and complications of coronary angiogram will be explained to the patient like reperfusion arrhythmias, artery rupture, bleeding, infections.  Subsequently patient with established Coronary Artery Disease had undergone CAROTID DOPPLER to estimate the carotid intima media thickness.  Patient were examined in supine position with head tilted backward. After the carotid arteries will be located by B mode ultrasonography Equipped with 7.5mhz linear array transducer. The probe was rotated right angle to obtain and record a longitudinal image of anterior and posterior walls. The measurement can vary from one observer to another.  The maximum IMT will be measured at the near and far wall of common carotid artery, the bifurcation and the internal carotid arteries and were expressed as a mean aggregated value.  Lipid profile after 12 hours of overnight fasting will be done and total cholesterol will be measured by pap method, Triglycerides by Pap method LDL:HDL ratio (HDL by PEG Precipitation method and LDL by Friedewald's formula).  There was signification correlation between carotid intima media thickness with LDL ,total cholesterol, tryglycerides (p<0.05) No significant correlation was seen between Carotid intima media thickness with HDL, Age. The mean Age in Diabetic group was 53.67, Diabetic with Hypertension group was 52.26, Hypertensive group was 57.5 and No risk factor group was 52.3 Therefore, the only effective approach to restrict the health burden is to prevent the diseases from developing at the earliest possible stage of atherosclerosis.

Comparison of lipid profiles between the risk factors
Thus, screening for biomarkers for detecting early stage asymptomatic vascular atherosclerosis are needed.
Carotid intima-media thickness is a valuable research tool that can be used as surrogate end points in clinical trials .1 This study was conducted on 50 patients at Yenepoya medical college, Mangalore.
All the patients were newly diagnosed coronary artery disease. CIMT was measured by B mode ultrasonagraphy and fasting lipid profile were measured. Age, Gender did not show any significant correlation. In clinical practice, measurement of CIMT greater than 1.0mm in the common carotid artery or presence of plaque may support an early intervention therapy. CIMT can also be used to assess safety and efficacy of cardiovascular medicines . 4

Conclusion:-
Carotid intima media thickness measured through Mode ultrasonagraphy was found to be significantly correlated with lipid profile. Thus, it can be used to assess the risk of cardiovascular diseases as it also correlated to increase LDL-CHOLESTEROL and total cholesterol and thus both are predictive markers for premature cardiovascular diseases.