الفهرس 
ISCHEMIC HEART DISEASESOnly 14 pages are availabe for public view
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Abstract
Worldwide, cardiovascular diseases are estimated to be the leading cause of death and disability. Although cardiovascular death rates have declined in several developed countries in past decades, rates of cardiovascular disease have risen greatly in low-income and middle-income countries.
Estimation of cardiovascular risk has become the cornerstone of cardiovascular diseases’ prevention.
Although atherogenesis is a multi factorial process, abnormalities in lipoprotein metabolism are one of the key factors representing around 50% of the population developing cardiovascular disease.
This study was done to study the risk ratio of Apolipoprotein B/A-I in type 2 diabetic patients with acute coronary syndrome as compared to such a ratio in type 2 diabetic patients with stable ischemic coronary artery disease and to study the risk ratio of apolipoprotein B/A-I as compared to conventional lipid profile in both groups.
The study was conducted on 50 type 2 diabetic patients who came to the emergency room at Ain Shams University Hospital complaining of ischemic chest pain. The patients were divided into two groups: 25 patients with acute coronary syndrome and 25 patients with stable angina.
All patients were subjected to thorough history taking, complete physical examination, 12 leads surface ECG, chest X-ray, transthoracic echocardiography and laboratory investigations including cardiac enzymes, renal functions, liver functions, complete blood count, glycated hemoglobin (HBA1c), lipid profile and apolipoprotein B/A-I ratio within 24 hours of hospitalization.
In the present study, assessing lipid profile revealed that total cholesterol, LDL, HDL and LDL/HDL ratio proved to be of high statistical significance (P < 0.01) as a predictor for acute coronary event while triglycerides and total cholesterol/HDL ratio were statistically non significant (P > 0.05) as a predictor for acute coronary event.
Assessing apolipoproteins levels revealed that apolipoprotein B, apolipoprotein A-I and apolipoprotein B/A-I ratio were statistically highly significant (P < 0.01) as a predictor for acute coronary event.
Correlating apolipoprotein levels to conventional lipid profile revealed that, using apolipoprotein B/A-I ratio was a stronger predictor for acute coronary event than conventional lipid profile with a 60% sensitivity (compared to 48%), 88% specificity (compared to 76%), 83% positive predictive value (compared to 66.667%), 68.7% negative predictive value (compared to 59.375%) and 86.6% accuracy (compared to 62%) at a cutoff point for this ratio of more than 0.93.
This study concluded that, apolipoprotein B, apolipoprotein A-I and apolipoprotein B/A-I ratio were independent significant predictors of acute coronary event and apolipoprotein B/A-I ratio was a stronger predictor for acute coronary event than the conventional lipid profile in type 2 diabetic patients.