Predictive value of triglycerides to high density lipoprotein ratio in patients with first attack of acute coronary syndrome.

OBJECTIVES: To identify patients who are at risk for a first cardiovascular event, mitigate the risk, and institute early intervention. The triglyceride to high-density lipoprotein-C (TG/HDL-C) ratio has been found to be a very useful biomarker for directing treatment and prevention therapy. METHODS: This retrospective cross-sectional study included adult patients (aged >18 years) experiencing first-time acute coronary syndrome (ACS). We examined all patient databases for a definite diagnosis of angina, non-ST segment elevation myocardial infarction (NSTEMI), or ST-segment elevation myocardial infarction (STEMI). Lipid profiles were obtained prior to or at the time of admission. RESULTS: A total of 265 patients were included in the study (mean age 57.83 ± 11.4 years) and 79.2% were men. Male gender, presence of diabetes, raised total cholesterol, raised low-density lipoprotein (LDL), and raised troponin level on admission were significantly positively correlated with STEMI (p=0.004, p=0.001, p<0.001, and p<0.001), whereas TG/HDL-C ratio was significantly negatively correlated with STEMI (p=0.048), while there was no significant results with NSTEMI (p=0.264) and angina (p=0.326). Total cholesterol and raised low-density lipoprotein (LDL) were significantly positively correlated with NSTEMI (p=0.013 and p=0.024). CONCLUSION: Patients with first-time ACS may not have an increased TG/HDL-C ratio. High LDL levels had the most significant association with an ACS event, along with total cholesterol and diabetes. Further research is needed on a larger scale to determine the association of TG/HDL-C ratio with ACS and differentiate the different types of ACS events according to their clinical and laboratory characteristics.

Assessing the readiness of hospitals in Riyadh Province for efficient and timely stroke management: A pilot study.

OBJECTIVES: To assess the readiness of hospitals in Riyadh to establish acute stroke centers by following the Australian Clinical Guidelines for Stroke Management. METHODS: This study was a quantitative cross-sectional observational study conducted among hospitals in the central region of Saudi Arabia (Jan 2018 - April 2018). A self-administered questionnaire/survey tool was adapted from an Australian survey developed by the Stroke Foundation in Melbourne, Australia.The data were analyzed using SPSS version 21.0. Appropriate statistical tests (chi-square and Fisher's exact test) were used for bivariate analyses. RESULTS: A total of 3932 stroke patient visits were recorded in 37 hospitals in the central region of Saudi Arabia. The most common limitations of acute stroke services were that 25 (67.57%) of the hospitals had no stroke unit and 21 (56.76%) had inadequate clinical staff. Magnetic resonance imaging and computed tomography were available in 32 (86.49%) and 36 (97.30%) hospitals, respectively. Only two-thirds of hospitals 25 (67.57%) followed protocols for rapid Emergency Department (ED) triage. CONCLUSION: We found that most of our hospitals were not fully prepared to address acute stroke management in a manner that was reasonably consistent with international guidelines. We recommend raising the hospital's requirements a higher level to be in line with the stroke guidelines.