Non-HDLC/HDLC ratio is a better marker of dyslipidaemia related cardiovascular risk in African patients with acute coronary syndrome

Objectives: Although recent studies suggest that the African population is becoming exposed to more risk factors of coronary artery disease, there is limited research on lipid profiles and their usefulness in assessing  risk of acute coronary syndrome in this population group. The main objective of this study was to determine the utility of lipoprotein ratios in risk profiling of dyslipidaemia related acute coronary syndrome.Design: A retrospective analysis of lipograms and clinical records of Black African patients admitted to the critical care unit with acute coronary syndrome from January 2006 to December 2010.Setting: Chris Hani Baragwanath Academic Hospital a 3200 bed hospital located in Gauteng, South Africa.Subjects: Clinico-demographic data was abstracted for 1006 participants of whom 56% were male (n=567) who presented with ACS from January 2006 to December 2010. The median age of the participants was 58 (IQR 49-67) years.Main Outcome Measures: Lipid profiles and lipoprotein ratios.Results: Males had statistically significantly higher median serum Triglycerides (TG) concentrations (1.5 vs 1.2 respectively, p = 0.001) while females had statistically significantly higher High Density Lipoprotein Cholesterol (HDLC) levels (1.2 vs 1.0 respectively, p = 0.001). HDLC showed the highest overall dyslipidaemia proportions (60%) and was higher in males (71% vs 47% respectively, p<0.001) while TG dyslipidaemia was also significantly higher in males (41% vs 30%, p<0.001). The non-HDLC/HDLC ratio showed the highest level of dyslipidaemia as 94% of the participants had a ratio greater than the 0.95 cut-off.Conclusion: Non-HDLC/HDLC ratio may be a better marker of dyslipidaemia related cardiovascular risk than the traditional isolated parameters

Implementation of POCT in the diabetic clinic in a large hospital

Aim: Point-of-care testing (POCT) is gaining renewed interest, especially in resource-limiting primary health care, due to rise in prevalence of communicable and non-communicable diseases hence POCT needscontinuous appraisal.Methods: Random glucose and glycated haemoglobin (HbA1c) were measured in 104 diabetic patients using standard laboratory multichannel analyzer 917. The utility of venous blood compared to capillary blood in measuring HbA1c was evaluated in a subset of 20 patients using a POCT device, DCA Vantage. Lastly, the POCT was validated against the laboratory multichannel analyser 917, in measurement of HbA1c in a second subset of 46 patients.Results: Random blood glucose levels and HbA1c levels moderately correlated (r2 = 0.56; p < 0.0001). Random glucose tests showed that 41% of the patients had poor glycaemic control while HbA1c showed 74%. Venous and capillary blood in HbA1c showed strong correlation (r2 = 0.89440; p < 0.001. There was also strong correlation (r = 0.9802; p < 0.0001) in HbA1c measured using the DCA Vantage and the standard laboratory analyser, Multichannel Analyser 917.Conclusion: Venous or capillary blood can be used in POCT for HbA1c. POCT is ideal for monitoring glucose control and management of diabetes in resource-limited countries such as South Afric