Role of lipid profile in proven premature coronary artery disease and its first degree relatives- a tertiary care hospital based study in South-Eastern region of Rajasthan, India

Deepika Mittal, Shivraj Meena, Rahul Meena, Kirti Shekhawat


Background: Cardiovascular diseases have become a leading cause of morbidity and mortality in adult population of Indian sub-continent. Aim of the study was to compare the serum lipid patterns in patients with proven premature CAD and its first degree relative in a tertiary care hospital of South-eastern region of Rajasthan, India.

Methods: 200 patients with the primary diagnosis of premature coronary artery disease were enrolled. These patients and their 643 first-degree relatives, who were in the coronary age group 25 years and above also enrolled for the purpose of the study. Fasting lipid profile was estimated.

Results: 36.5% of the males and 4.5% female patients were having abnormal cholesterol levels. 30.5 % of male of premature CAD were having high LDL levels as compared to only 2.5% of the females (p<0.05). High LDL level was 33.0%. Low HDL cholesterol in CAD patients were in 36.0% of males and 4.0% of the females (p<0.05). High Triglyceride levels (53.5%) in the CAD patients were 46.5% males and 6.5% females. (p<0.05). Irrespective of sex, majority of relatives  (70.7%) were having desirable total cholesterol levels while high total cholesterol was there in only 10.1% of the relatives.21.4% of male relatives of CAD patients were having abnormal LDL levels as compared to 7.4% of the females (p<0.05).

Conclusions: For hyper cholestolaemia, routine screening of all adults older than 20 years is recommended. Therapeutic targets for lipid levels are recommended depending on overall risk for patients with CAD or a CAD risk equivalent such as diabetes or peripheral arterial disease.



Lipid profile, Coronary artery disease, Cholesterol, HDL

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World Health Report 1997. Geneva: World Health Organization.

Murray CJL, Lopej AD. Global comparative assessments in health sector. Geneva World Health Organization. 1992.

Pearson TA. In: DT Jamison (ed) Disease Control Priorities in developing countries. New York: Oxford University Press. 1993:577-99.

Enas EA, Yusuf S, Mehta JL. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol. 1992;70:945-9.

Mc Keigue PM, Miller GJ, Marmot MG. Coronary heart disease in south Asians overseas: a review. J Clin Epidemiol. 1989;42:597-609.

Coronary heart disease in Indians overseas. Lancet. 1986;1:1307-8.

McKeigue PM, Marmot MG, Adelstein AM, Hunt SP, Shipley MJ, Butler SM, et al. Diet and risk factor for coronary heart disease in Asian Indians in Northwest London. Lancet. 1985;16:1086-90.

Miller GJ, Kotecha S, Wilkinson WH, Wilkes H, Stirling Y, Sanders TA, et al. Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London. Atherosclerosis. 1988;70:63-72.

Reddy S, Sanders TA. Lipoprotein risk factors in vegetarian women of Indian descent are unrelated to dietary intake. Atherosclerosis. 1992;95:223-9.

Mc Keigue PM, Ferrie JE, Pierpoint T, Marmot MG. Association of early onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinaemia. Circulation. 1993;87:152-61.

CADI Study Group. Why there is an epidemic of malignant CAD in young Indians? Asian Journal of Clinical Cardiology. 1998;1:43-59.

World Health Report 2000; reducing risks, promoting healthy life, Geneva, WHO. 2002.

Chaudhari S, Das S, Das NG. A statistical study on coronary heart disease. Indian Heart J. 1996;18:391-402.

Mckeigue PM, Syndercombo MMG, Court VD, Cottiee DE, Rahmans S, Reimersma RA. Diabetes, hyperinsulinaemia and coronary risk factors in Bangladeshis in East London. Br. Heart J. 1998;60:390-6.

Law MR, Wald NJ, Wu T, Hackshaw A, Baileyet A. Systematic underestimation of association between serum cholesterol concentration and ischemic heart disease in observational studies: Data from the BUPA study. BMJ 308: 363. 1994.

Stamler J, Daviglus ML, Garside DB, Dyer AR, Greenland P, Neaton JD. Relationship of baseline serum cholesterol levels in three large cohorts of younger men to long-term coronary, cardiovascular and all cause mortality and to longevity. JAMA. 2000;284;311.

Goel PK, Bharti BB, Pandey CM, Singh U. A tertiary care hospital based study of conventional risk factors including lipid profile in proven coronary artery disease. Indian Heart J. 2003;55:234-40.

American Diabetes Association. Diabetes care. 2006;23:381-9.

Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III) final report. Circulation 2002;106;3143-421.

Dwivedi S, Dwivedi G, Chaturvedi A, Sharma S. CAD in young: Here do familial or faulty life style or both. JIACM. 2000;1(3):223.

Vyas A, Vyas J, Saxena HC, Gauri LA. A study of coronary risk factors in patients with MI. Indian practitioner. 1994;47:345-7.

Dwivedi S, Anupam P, Chaturvedi A. Cardiovascular risk. Factors in young coronary heart disease patients around East Delhi. South Asian J Preventive Cardiology. 1997;1:21-6

Krishnaswamy S, Sethi KK. Conventional risk factors for CAD in Indians - a global Perspective.1998.

Lateef SAA, Subramanyam G. Prevalence of CAD and CAD risk factors in an urban population of Tirupati. Indian Heart J. 2007;59(2):157-64.

Thompson GR. Dyslipidemia in clinical practice. Heart. 2004;90(8):949-55.

Allen JK1, Young DR, Blumenthal RS, Moy TF, Yanek LR, Wilder L, et al. Prevention of hypercholesterolemia among siblings of persons with premature CAD. Arch Intern Med. 1996;156(15):1654-60.

European Atherosclerosis Research Study (EARS): Study of Young adults with a parental history of premature CAD. Circulatin. 1994;89;1967.