A comparative study of novel inflammatory markers (high sensitivity c - reactive protein and lipoprotein a) and ldl/hdl cholesterol ratio in acute coronary syndrome at tertiary care centre in central india

Background: In India, cardiovascular disease (CVD) is one of the leading causes of death. All subjects are not accurately predicted for risk of CVD by traditional risk factors. To improve the present risk prediction model, a search of novel biomarkers is required to recognize the risk of cardiovascular events. Novel biomarkers involved in inflammation cascade and developing atherosclerosis and coronary heart disease are of utmost importance. Aims and Objectives: To study high sensitivity C-reactive protein (hs-CRP), lipoprotein A and LDL/HDL cholesterol ratio in acute coronary syndrome (ACS) and its association with ACS severity. Materials and Methods: Eighty patients (aged 18-70 years of either sex) with ACS (diagnosed based on clinical history, clinical examination, electrocardiogram changes, and creatine phosphokinase-MB) were studied at a tertiary care hospital from 2017 to 2020. High Sensitivity C - reactive protein (hs-CRP), lipoprotein A, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were estimated from patients’ blood samples, and the association was obtained. Results: Incidence of ACS was highest in 56-65 years (28.75%) male (85%) patients. The most common diagnosis was ST-elevation myocardial infarction (78.75%). The hs-CRP levels and lipoprotein A were increased in 49 and 44 patients out of 80, respectively. Patients with high hs-CRP (n=43 of 48; p<0.0001) and lipoprotein A (n=32 out of 48; p=0.026) at admission are prone for going into complications. Conclusion: hs-CRP and lipoprotein A levels obtained at admission in ACS patients can be used to identify patients who are likely to develop significant complications in the immediate in-hospital course and predict the prognosis