AN INTERVENTION STUDY WITH INOSITOL HEXA NICOTINATE IN ISCHEMIC HEART DISEASE PATIENTS TREATED WITH STATIN AT A TERTIARY CARE HOSPITAL
Sabitha Panchagiri* and Chandrsekhar Valupadas
ABSTRACT
Background: Treating dyslipidemia to targets in accordance with ATP
III guidelines is an integral part of management in patients suffering
with Ischemic Heart Disease to prevent progression and to achieve
regression of atherosclerosis. Under treatment in this regard leads to
recurrent ischemic episodes. Objectives: 1. This study aims to
determine prevalence of inadequately treated lipids in patients with
IHD and receiving statins. 2. Improvement of lipid profile by an
intervention with Inositol Hexa Nicotinate. Materials and Methods: It
is a prospective, open labeled, simple randomized study. The study group consists of 83
patients with primary diagnosis of IHD from the outpatient department of Mahatma Gandhi
Memorial Hospital, Warangal during January 2011 to September 2011, and receiving statin
therapy as secondary prevention of ischemic recurrences. Type2 Diabetes Mellitus, primary
dyslipidemia, other co morbidities were excluded. From these 30 patients with low HDL-c
levels were enrolled in intervention study. These entire patient’s clinical data recorded and 14
hours blood samples were collected and estimated lipid profile and other parameters. Results
and Discussion: The study group consists of 83 IHD patients with a mean age of 57.73 ±
11.53, who had been treated with a statin for an average of 2.52 years. Borderline high
cholesterol levels (>200mg/dl) were present in 18.07%. Borderline high LDL-c levels
(>100mg/dl) were found in 34.93% and triglyceride levels (>150mg/dl) were found in
22.84%; low HDL-c levels were found in 80.72%. Before intervention with IHN, Triglyceride and LDL-c concentrations were 102±10.5 and 88.02±8.15 respectively. With IHN, LDL-c decreased to 62.77±6.74 (P= 0.0057**) and triglycerides to 78.96±8.71 (P=0.0061**) in the group with last observation. LDL-c and Triglyceride levels tended to decrease slightly. In 30 patients who completed the 6 week study period IHN increased HDL-c from 20.54±1.54 to 39.44±2.18 (P<0.0001****). Remarkably, Total cholesterol levels (from 128.9±8.52 to 119.6.78; P=0.234 ns) did not change significantly. We observed there were no adverse events possibly related to IHN treatment. Conclusion: This study so far demonstrated more than three quarter of subjects were inadequately treated for lipids particular LDL-c and HDL-c leaving them at risk of subsequent ischemic recurrences. Our study suggesting that addition of HDL-c increasing agent to existing therapy may improve the clinical outcome.
Keywords: Ischemic Heart Disease; Inositol Hexanicotinate Nicotinate; Low Density Lipoprotein; High Density Lipoprotein.
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