Institute of Biosciences and Technology, MGM University, Chhatrapati Sambhaji Nagar-431003.
Coronary Artery Diseases (CAD) represent a significant global health burden, predominantly affecting middle-aged populations as reported by WHO. This study aims to evaluate comprehensive biochemical parameters and cardiac marker enzymes in patients presenting with severe cardiac complications. In this cross-sectional study, fasting blood samples were collected from 200 confirmed cardiac patients (n=200; comprising both males and females) and analysed following standardized laboratory protocols using ERBA diagnostic kits. Patients were stratified based on age and gender for detailed analysis. Results demonstrated significantly elevated lipid profiles with Total Cholesterol (320 mg/dl), Triglycerides (270 mg/dl), and LDL-Cholesterol (240 mg/dl), accompanied by consistently decreased HDL-Cholesterol levels (<30mg>130 IU), SGPT (>135 IU), GGT (>131 IU), and ALP (>207 IU) levels. These findings indicate a significant comorbidity between CAD and hepatic dysfunction. This comprehensive investigation establishes a clear correlation between elevated lipid profiles, altered cardiac markers, and increased cardiac risk. The study concludes that intensive lifestyle modifications and dietary interventions are crucial for these patients, emphasizing the need for a holistic treatment approach combining cardiac and hepatic care.
The most popular disease among the 21st century is cardiovascular disease (CAD), according to the WHO, a total of 17.9 million people were died due to CAD (WHO-2019). Among, those 85% of these deaths are due to heart attack & stroke. Some of the common reasons which lead to CAD are Alcohol usage, Diabetes, Smoking, High Cholesterol, Physical inactiveness, Atherosclerosis, Diabetes, Diet, Stress, High Blood Pressure, Age Factor, HIV/AIDS, sleeping disorders such as Obstructive Sleep Apnea or Sleep Deprived (Insomnia) [1]. In order to support towards a healthy lifestyle and better diet plan following a proper medication for the cardiac patients in this busy and up surging world. We need to understand the importance of lipid profile and how it can be used to monitor the patients’ well-being, to protect from any uncertainties that could lead to CVD [2]. Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality worldwide, with a particularly high burden in developing countries like India. Coronary Artery Disease (CAD) happens when there is an occlusion due to cholesterol which is known as plaque. In this the heart muscles become hardened and narrow up creating a compact area in the inner wall of the heart. As urbanization and lifestyle changes continue to impact the population, the prevalence of cardiac disorders has seen a significant rise in recent years [3]. In this context, the study of lipid profiles and cardiac biomarkers in cardiac patients will give a potential idea to give proper remedial medicine or diet planning and change of life style, emerges as a crucial area of research with far-reaching implications for patient care and public health strategies. Lipid profiling is mainly done to check for the level of cholesterol and fats in the blood. This makes it easier for doctors to detect for any CVD or future strokes. Lipid profiles, which typically include measurements of low-density lipoprotein (LDL) is known as the “bad” cholesterol as it builds up and causes a blockage in the arteries, high-density lipoprotein (HDL) is known as “good” cholesterol as it helps remove other forms of cholesterol from the bloodstream, triglycerides are the “stored fats” in the body which is broken down when there is a need of energy in the body and total cholesterol is the total of all the cholesterol levels (HDL + LDL + 20% Triglycerides), have long been recognized as important indicators of cardiovascular health. Abnormalities in these lipid parameters, collectively known as dyslipidaemia, are strongly associated with an increased risk of atherosclerosis and subsequent cardiovascular events. In the Indian population, studies have shown a high prevalence of dyslipidaemia, often characterized by low HDL levels and elevated triglycerides, a pattern that differs from Western populations [4].
Effect of lipid profile and cardiac markers lead us to CAD. Complementing the lipid profile, cardiac biomarkers have revolutionized the diagnosis, risk stratification, and management of cardiac patients. These biomarkers, including troponins, creatine kinase-MB (CK-MB), and B-type natriuretic peptide (BNP), provide valuable information about myocardial injury, inflammation, and stress [5]. The use of high-sensitivity troponin assays, in particular, has significantly improved the early detection of acute myocardial infarction and has become an integral part of clinical decision-making in emergency departments worldwide [6].
The study of lipid profiles and cardiac biomarkers in the context of Hospital patients, offers a unique opportunity to explore these parameters in a diverse urban and semi-urban population of central India. This research is particularly relevant given the region's rapid urbanization, changing dietary habits, and increasing prevalence of sedentary lifestyles – all factors that contribute to the rising incidence of cardiovascular diseases [7]. Moreover, the genetic and ethnic diversity of the Indian population adds another layer of complexity to the interpretation of lipid profiles and cardiac biomarkers. Studies have shown that South Asians may have a different cardiovascular risk profile compared to other ethnic groups, with a tendency towards developing CVD at a younger age and with lower body mass indices [8]. Understanding these population-specific characteristics is crucial for developing tailored prevention and treatment strategies.
The present study aims to analyse the lipid profiles and cardiac biomarkers of cardiac patients admitted to Hospitals. By examining these parameters in conjunction with clinical presentations, co morbidities, and outcomes, the research seeks to get a better understanding of CVDs and to look out for prevention or precaution methods. Findings of this study have the potential to significantly impact clinical practice at Hospital and similar institutions in the region. By providing insights into the local patterns of dyslipidaemia and the performance of cardiac biomarkers, the research can inform the development of more effective screening programs, risk assessment tools, and treatment protocols tailored to the specific needs of this population [9]. Furthermore, this study contributes to the broader body of knowledge on cardiovascular health in India. As the country continues to grapple with the dual burden of communicable and non-communicable diseases, research that enhances our understanding of CVD risk factors and diagnostic tools is of paramount importance. The results may also have implications for public health policies, potentially guiding interventions aimed at primary prevention of cardiovascular diseases in the community. By emphasising on the characteristics of these important clinical parameters, the study aims to improve patient care, enhance risk prediction, and contribute to the development of targeted strategies for combating the growing burden of cardiovascular diseases in the region.
MATERIALS & METHODOLOGY
MATERIALS:
Experimental site: The experiment is conducted at MGM Hospital, Chh. Sambhaji Nagar during the year 2024.
In EDTA tubes 5 ml of blood samples were collected from a total of 200 patients.
Methodology:
Study Design:
Conduct a prospective observational study of cardiac patients admitted to Hospital over a 6-month period. Include adult patients (age 18+) diagnosed with acute coronary syndrome, heart failure, or other cardiac conditions. Exclude patients with severe co morbidities that could significantly impact biomarker levels. Categorize patients according to their different age groups and sex [10].
Laboratory Analysis:
Analyze blood samples in the hospital's clinical laboratory using standardized assays. Measure lipid profiles using enzymatic colorimetric methods. Quantify cardiac biomarkers using high-sensitivity immunoassays. Ensure all tests are performed according to manufacturer protocols with appropriate quality controls. In this study we used ERBA company kits for testing lipid profile - Total cholesterol (Code no.–120168) [11], triglycerides (Code no.–120250) [12], LDL-C (Code no.-121261) [13], HDL-C (Code no.-121260) [14] and cardiac biomarkers – SGOT (Code no.-120902) [15], SGPT (Code no.-120903) [16], GGT (Code no.-122135) [17], ALP (Code no.-120247) [18] to obtain result accuracy. Standard statistical procedures followed to analyze comparison between lipid profiles, cardiac biomarkers, and their clinical outcomes.
Results
The present investigation of lipid profile and cardiac biomarkers of Hospital population is analysed and evaluated the values in following tables and figures. The normal range of lipid profile such as Cholesterol (mg/dl), Triglycerides (mg/dl), LDL – C (mg/dl), HDL – C (mg/dl), is expressed in Table 1 where as in the Table 2 lipid profile of cardiac patients is evaluated.
Table 1 – Lipid Profile of Patients (Normal).
|
Parameters |
20 – 40 (yrs) |
41– 60 (yrs) |
> 60 (yrs) |
|||
|
Gender |
Male |
Female |
Male |
Female |
Male |
Female |
|
Total Cholesterol (mg/dl) |
177.40 ± 4.87 |
199.65 ± 3.80 |
196.66 ± 5.22 |
203.02 ± 1.64 |
182.36 ±3.46 |
211.04 ± 5.97 |
|
Triglycerides (mg/dl) |
136.29 ± 3.74 |
155.09 ± 3.55 |
141.46 ± 2.38 |
154.5 ± 2.53 |
143.32 ±5.58 |
179.42 ± 3.35 |
|
LDL – C (mg/dl) |
104.92 ± 5.43 |
120.54 ± 4.22 |
116 ± 2.07 |
130.5 ± 0.56 |
107.10 ±2.92 |
130.71 ± 2.27 |
|
HDL - C (mg/dl) |
45.21 ± 1.78 |
48.09 ± 1.68 |
52.37 ± 4.56 |
41.62 ± 1.60 |
46.60 ±3.20 |
44.44 ± 4.7 |
Table 2 – Lipid Profile of Patients (Cardiac)
|
Parameters |
20 – 40 (yrs) |
41 – 60 (yrs) |
>60 (yrs) |
||||
|
Gender |
Male |
Female |
Male |
Female |
Male |
Female |
|
|
Total Cholesterol (mg/dl) |
325.73 ± 2.17 |
325.28 ±2.06 |
326.82±2.60 |
326.89 ±1.51 |
325.41 ±2.34 |
326.55 ±2.13 |
|
|
Triglycerides (mg/dl) |
274.39 ± 2.97 |
272.81 ±2.16 |
274.78±2.67 |
273.79 ±1.36 |
272.07 ±2.28 |
237.02 ±1.69 |
|
|
LDL – C (mg/dl) |
240.75 ± 1.67 |
241.5 ±1.64 |
241.34±2.32 |
242.41 ±1.34 |
241.32 ±2.20 |
241.36 ±2.20 |
|
|
HDL - C (mg/dl) |
45.21 ± 1.78 |
48.09 ± 1.68 |
52.37 ± 4.56 |
41.62 ± 1.60 |
46.60 ±3.20 |
44.44 ± 4.7 |
|
Fig 1: Comparison of Total Cholesterol (mg/dl) levels of patients of all Age Groups
Fig 2: Comparison of Triglyceride (mg/dl) levels of patients of all Age Groups
Fig 3: Comparison of LDL-Cholesterol (mg/dl) levels of patients of all Age Groups
Fig 4: Comparison of HDL-Cholesterol (mg/dl) levels of patients of all Age Groups
From the above analysis we can draw conclusions that the levels of Total cholesterol are raised from the normal level as 325 mg/dl for cardiac patients and 177 – 211 mg/dl for normal patients.
Table 3 shows the normal range of Cardiac Biomarkers – Non - functional enzymes such as SGOT (u/l), SGPT (u/l), GGT (u/l), ALP (u/l), whereas in Table 4 the level of Cardiac Biomarkers of Cardiac patients is reduced.
Table 3 – Cardiac Biomarkers-Non-functional enzymes (Normal)
|
Parameters |
20 – 40 (yrs) |
41 – 60 (yrs) |
> 60 (yrs) |
|||
|
Gender |
Male |
Female |
Male |
Female |
Male |
Female |
|
SGOT (u/l) |
41.14 ±1.93 |
34.09 ± 0.88 |
47.62 ± 3.16 |
38.12 ± 1.44 |
36.90 ±0.99 |
42.42 ± 1.13 |
|
SGPT (u/l) |
42.92 ±1.15 |
36.5 ± 2.57 |
43.87 ± 0.85 |
42.87 ± 1.28 |
42 ±1 |
44.85 ± 1.42 |
|
GGT (u/l) |
31.85 ±0.52 |
26.72 ± 2.36 |
34.25 ± 0.72 |
32.87 ± 1.28 |
32 ±1 |
42 ± 1.39 |
|
ALP (u/l) |
115.50 ±1.02 |
108.63 ± 1.86 |
120. 50 ± 1.45 |
118.25 ± 2.88 |
115.70 ±2.15 |
126.14 ± 3.25 |
Table 4 – Cardiac Biomarkers- Non-functional enzymes (Patients)
|
Parameters |
20 – 40(yrs) |
41 – 60 (yrs) |
> 60 (yrs) |
|||
|
Gender |
Male |
Female |
Male |
Female |
Male |
Female |
|
SGOT (u/l) |
135.25±2.77 |
132.53 ± 2.12 |
136.95 ± 2.71 |
133.79 ± 1.73 |
131.32 ±2.62 |
134.02 ± 2 |
|
SGPT (u/l) |
135.25±2.77 |
132.53 ± 2.12 |
136.95 ± 2.71 |
133.79 ± 1.73 |
131.32 ±2.62 |
134.02 ± 2 |
|
GGT (u/l) |
135.25±2.77 |
132.53 ± 2.13 |
136.95 ± 2.71 |
133.79 ± 1.73 |
131.32 ±2.62 |
134.02 ± 2 |
|
ALP (u/l) |
207.75±5.08 |
210.87 ± 2.71 |
216.08 ± 3.22 |
208.60 ± 3.38 |
208.75± 3.31 |
214.02 ± 2.40 |
Fig 5: Comparison of SGOT (U/L) levels of patients of all Age Groups
Fig 6: Comparison of SGPT (U/L) levels of patients of all Age Groups
Fig 7: Comparison of GGT (U/L) levels of patients of all Age Groups
Fig 8: Comparison of ALP (U/L) levels of all Age Groups
The cardiac biomarkers demonstrated significant elevations that suggests potential liver and heart damage. SGOT levels were raised extensively ranging from 131 – 137 u/l whereas the normal range is from 36 – 47 u/l. Similarly, the levels of SGPT indicates hepatic stress, GGT & ALP indicating liver and metabolic dysfunction.
DISCUSSION
The landscape of cardiovascular disease (CVD) management and diagnosis has evolved significantly over recent decades, presenting distinct patterns between developing and developed nations. While developed countries have witnessed declining CVD mortality through advanced healthcare systems and improved risk factor management, developing nations face increasing prevalence due to demographic transitions and inadequate healthcare infrastructure [19]. The evolution of cardiac biomarker assessment has revolutionized acute coronary syndrome (ACS) diagnosis, progressing from basic markers like aspartate aminotransferase to sophisticated high-sensitivity cardiac troponins. Contemporary diagnostic approaches incorporate multiple biomarkers, including ischemia-modified albumin, NT-proBNP, and heart-type fatty acid binding protein, enhancing diagnostic accuracy across different ACS stages. Epidemiological studies reveal concerning trends in dyslipidaemia prevalence, particularly in developing regions, with notable urban-rural disparities and varying patterns of lipid abnormalities. Research indicates that approximately 72% of studied populations exhibit low HDL-C levels, while nearly 80?monstrate at least one abnormal lipid parameter. The evaluation of acute chest pain remains challenging, especially in cases of non-ST-segment elevation myocardial infarctions, emphasizing the critical role of rapid biomarker assessment in risk stratification and treatment initiation. This comprehensive understanding of cardiovascular health patterns, diagnostic methodologies, and risk factors underpins the urgent need for strengthened healthcare systems and population-level interventions to address the growing burden of cardiovascular disease globally [20]. The results of the current study indicate the highest values of lipid profile and non - functional enzymes among all age groups. The highest cholesterol LDL, Triglycerides, indicates the lipid associated disorders such as obesity and diabetes [21]. The abnormalities of biomarker enzymes such as SGOT, SGPT, GGT, and ALP indicates the more absorption syndromes and hyperthyroidism even parathyroids [22] when compared to the normal values of biomarker enzymes GGT levels observed as than the normal it indicates the liver disorders such as liver cirrhosis or fatty liver [23]. In a current investigation of lipid profiles, HDL – Cholesterol levels are decreased drastically indicated the fatty liver and severe coronary artery disease. The increased level of SGOT and SGPT have the significance in diseases such as necrosis and myocardial infraction. Hence the study proves that cardiac patients are suffering with not only CVD but also liver related diseases. The reports on cardiac marker enzymes indicates the failure of liver, kidneys and heart tissues. Through dedicated research, practical work on the topic started with collection of blood samples of cardiac patients of different age groups from the hospital to check for their lipid profiling and cardiac biomarker tests. The samples are first categorized based on the patient's age groups (20-40yrs, 41-60yrs and >61yrs) and genders (males and females). Standardized tests are performed using ERBA company kits and protocols of the same are used. Visual representation of the outcome is shown in the form of tables for normal patients and cardiac patients whereas graphs are used for comparison between the different age groups and between different genders [24]. We are doing a study to learn more about cholesterol levels and heart disease markers in local patients. With the way people are living and cities growing, this research aims to find better ways to diagnose, prevent, and treat heart problems in the community. The focus is on the specific health needs of people in the area, so the results can improve care, shape health policies, and reduce heart disease. By finding ways to detect issues early and provide more personalized treatments, the study hopes to make a real difference in the region’s health. [25, 26, 27]
CONCLUSION
This study checked the heart health of 200 patients by looking at their cholesterol levels and other markers. Doctors tested bad cholesterol (LDL), good cholesterol (HDL), triglycerides, and enzymes like SGOT and SGPT to see their effects on the heart. The goal was to find common problems and improve treatment for heart patients. The study found that many patients had high bad cholesterol (LDL) and triglycerides, which are harmful to the heart. Most also had low good cholesterol (HDL), which raises the risk of heart disease. This means many patients had both heart and liver-related health concerns. These results show how important it is to get regular health checkups, eat healthy foods, stay active, and reduce stress to stay healthy. Early testing and treatments that match each person’s needs can help prevent serious problems. This study gives useful information to help doctors and hospitals improve care and reduce heart disease in the community.
ACKNOWLEDGEMENT
We would like to express my deepest gratitude to the Director, HOD and Staff of Institute of Biosciences and Technology, MGM University, Chh. Sambhajinagar, for providing the necessary infrastructure and academic support throughout the research project. We also extend our sincere gratitude for the technical support, laboratory facilities, and research instruments made available by the Central Pathology Laboratory of MGM Hospital.
REFERENCES
Dr. Raja Kumar Parabathina*, Dilnawaz Ansari, Kishor Deshmukh, Yashashri Alamwar, Studies on evaluation of Lipid Profile and Cardiac Biomarkers of Hospital Population, Int. J. of Pharm. Sci., 2024, Vol 2, Issue 12, 543-552. https://doi.org/10.5281/zenodo.14282423
10.5281/zenodo.14282423
