• Cardiology Clinical Trials
• Myocardial Infarction
• Lipid Disorders
• Diabetes Mellitus

In 2004–2005, Trinidad and Tobago had the highest percentage of deaths from cardiovascular disease (CVD) and diabetes in the Caribbean [Chinnock P. Caribbean Health 2001]. Patients with diabetes or hypertension are at higher risk of CVD with worse outcomes than nondiabetic individuals [Falko JM et al. Curr Diabetes Rev 2005]. High uric acid levels are also a risk factor for insulin resistance syndrome [Bonora E et al. Eur J Clin Invest 1997].

Nalini Maharaj and colleagues from the University of the West Indies, Trinidad and Tobago, presented a poster on altered lipid profile and serum uric acid with the risk of myocardial infarction (MI) among diabetic and nondiabetic hypertensive patients. The primary objective was to improve understanding of the associations among altered lipid profile, serum uric acid, and the risk of MI.

The study included 672 adults who were treated for hypertension in public health clinics between 2005 and 2009. Health records were used to obtain each patient's history, lipid levels, blood pressure, and serum uric acid values.

The prevalence of MI was 25.45%, with males accounting for 52.6% and females accounting for 47.4%. The modal age group for MI was 61 to 70 years. MI rate was higher in hypertensive type 2 diabetics with altered lipid profiles (23.9%) than in nondiabetic hypertensive patients (7.7%). Diabetes (OR, 3.741), altered lipid profile (OR, 13.096), and age group (OR, 1.444) were all associated with an increased odds of MI. Increasing serum uric acid quartile (p=0.029) was also associated with MI.

The data suggest that altered lipid profile and elevated serum uric acid are associated with MI in hypertensive patients with diabetes. While dyslipidemia is an established risk factor for MI and a current therapeutic target, further studies that adjust for other clinical and laboratory covariates are needed to understand if serum uric acid is an independent predictor of MI and whether this measurement is a useful clinically in directing therapeutic decision-making.

• © 2011 MD Conference Express