Jegan, A (2010) A Study on Prevalance of Elevated Highly Sensitive C-Reactive Protein in Acute Vascular Events. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Estimating global trends in the burden of disease, particularly CVD, is aided by examining regional trends. Because 85 percent of the world's population lives in the low- and middle-income countries, global rates of CVD are largely driven by rates in these countries. Even as rates fall in high-income countries, worldwide CVD rates are accelerating because most low- and middle-income countries are entering the second and third phases of the epidemic transition, marked by rising CVD rates. The economic impact of chronic diseases could be substantial as this transition proceeds. Over the next decade or so, countries such as China, India, and Russia could forego between $200 billion and $550 billion in national income as a result of heart disease, stroke, and diabetes. In 1990 CVD accounted for 28 percent of the world's 50.4 million deaths and 9.7 percent of the 1.4 billion lost DALYs. By 2001, CVD was responsible for 29 percent of all deaths and 14 percent of the 1.5 billion lost DALYs. By 2020, the population will grow to 7.8 billion and 32 percent of all deaths will be due to CVD, and by 2030, when the population is expected to reach 8.2 billion, 33 percent of all deaths will be caused by CVD. By 2030, the WHO predicts that worldwide CVD will cause 24.2 million deaths. Of these, 14.9 percent of deaths in men and 13.1 percent of deaths in women will be due to CHD. Stroke will be responsible for 10.4 percent of all male deaths and 11.8 percent of all female deaths. AIMS AND OBJECTIVES: 1. To determine the Prevalance of Elevated HsCRP in 50 Patients with Acute Vascular Events. 2. To compare with 50 controls of non vascular acute event. 3. To determine role of HsCRP in determining the morbidity and mortality. 4. To study the prognostic implication of HsCRP in acute vascular events. 5. To analyse the levels in patient with out any other specific CVS risk factors. MATERIAL AND METHODS: Study Population: A total of 50 patients were enrolled for the study from who attended the in patient clinics of the institute of Internal Medicine and department of cardiology. Patients are selected for the study who satisfied all the inclusion and exclusion criteria. Written consent was obtained from all patients participating in the study. Age and sex matched controls (50) were also studied for comparison and meaningful interpretation of data. The controls were recruited from other acute cases that were recruited from the wards; appropriate controls were recruited from the wards. All patients and controls were not from a single ethnic background. Study Duration: This study was conducted for a period of eighteen months from January 2008 to September 2009. Study Design: A single centre matched care- control study design was chosen. METHODS: Detailed clinical history were taken from each patients and a completes review of their case notes performed. A complete clinical examination of the nervous system and cardiovascular system was done for each patient. LABORATORY METHODS To all selected patients, following investigations were taken. ECG, ECHO, CPK MB, CT BRAIN, FBS, FLP, HsCRP, Other relevant investigations. INCLUSION CRITERIA: For Cases: 1. Age more than 12 years, 2. Acute myocardial infarction, Evidenced by ECG, elevated CK MB, or ECHO, 3. Ischemic stroke. Two CT BRAIN taken at least 3 days gap showing signs of ischemia, 4. Unstable angina, Evidenced by ECG or elevated CK MB. 5. Those who are willing for study. FOR CONTROL: 1. Age more than 15 less than 60, 2. Presence of any illness, 3. Event should be acute, 4. No cardiovascular risk factors. Exclusion Criteria: 1. Age less than 15 and more than 60, 2. Smoking, 3. Alcoholism, 4. Patient with previous attacks, 5. Other inflammatory conditions: a. SLE, b. Scleroderma, c. Rheumatoid arthritis, d. Other Connective Tissue Disorders, 6. Immunosuppresant therapy, 7. Patient lost followup. STATISTICAL ANALYSIS: The significance of difference between two proportions was indicated by the chi-square (x2) statistic. The significance of difference in mean between two groups was calculated by student t-test. Variables were considered to be significant if (P<0.05). CONCLUSION: In this study it is clearly shown that most of patient selected had: • Very high prevalence of elevated HsCRP patients with acute vascular events. • There is definite association of HsCRP in acute vascular events than other non vascular conditions. • The analysis in patient without any specific cardiovascular risk factors shows definite relative correlations. • Probably HsCRP may play a role in pathogenesis as mentioned in the literature above which needs further studies. • Level of HsCRP has a definite role in determining the mortality in patients with acute vascular events.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Prevalance ; Elevated Highly Sensitive C-Reactive Protein ; Acute Vascular Events. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 29 Mar 2018 02:34 |
| Last Modified: | 29 Mar 2018 02:34 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6723 |
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