Variability in lipid profile before and after coronary artery bypass grafting (CABG)

Objective: To investigate changes in total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides in serum of Pakistani patients before, immediately after and 5 days post CABG. Method: Serum samples from 31 consecutive Pakistani angina patients undergoing CABG at the Aga Khan University Hospital were analyzed for total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides using kit methods. Results: Immediately after CABG, there is a significant decline in the mean levels of serum'cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. However, 5 days post CABG, there is a significant increase in the concentrations of total cholesterol (P=0.01) and LDL cholesterol (P=0.001) in nondiabetic angina patients (n=13). Among the diabetic group of patients (n=18), the levels of total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides went back to the pre-operative levels within 5 days post CABG. Compared to European patients, Pakistani patients tend to have very low levels of HDL cholesterol (24.9 ± 7.1 mg/dl) and nigh levels of triglycerides (185 ± 50 mg/dl) on day 5 post CABG. Conclusion: Since risk of mortality following CABG increases with low level of HOL cholesterol and high level of triglycerides, close monitoring and treatment of high lipid levels of Pakistani patients following CABG is necessary to prevent further coronary events.