Browsing by Author "Dhungana, Murari"
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Publication Effectiveness of Lower Range of High-intensity Statin Therapy in Lowering LDL-C among STEMI Patients(Nepal Health Research Council, 2024) Prajapati, Dipanker; Adhikari, Chandra Mani; Timalsena, Birat Krishna; Maharjan, Nira Shrestha; Dhital, Rolina; Khatri, Anjali; Bogati, Amrit; Manandhar, Reeju; Dhungana, Murari; Safi, Md. Sajjad; Khan, Barkadin; Ghimire, Vijay; Roy, Rahul; Adhikari, Puja; Dhungana, Suraksha; Rajbhandari, SujeebBackground: Lipid-lowering is an important intervention to reduce cardiovascular morbidity and mortality after ST-Elevation myocardial infarction. This study aimed to assess the proportion of such patients achieving guideline-directed therapeutic low-density lipoprotein cholesterol targets while on lower-range high-intensity statin treatment. Methods: This is a cross-sectional study conducted in Shahid Gangalal National Heart Centre, a tertiary cardiac center in Kathmandu, Nepal, from November 2021 to July 2022 among admitted acute ST-Elevation myocardial infarction patients who were prescribed a lower range of high-intensity statin therapy, Atorvastatin 40mg and Rosuvastatin 20 mg. Clinical characteristics were collected, including lipid parameters at baseline during admission and three months after the treatment. The proportion attaining the guideline-recommended levels was calculated and compared between each statin group. Results: A total of 240 patients were included in this study. The target low-density lipoprotein cholesterol level of less than 1.4mmol/L was noted only in 16.3% and the target reduction by ?50% from baseline only in 7.1%. Just 3.3 % achieved a target of <1.4 mmol/L and ?50% reduction from baseline. However, 40.8% of the participants in our study met the 2012 European Society of Cardiology guidelines’ target achievement of less than 1.8 mmol/L. Conclusions: The overall proportion of patients attaining recommended low-density lipoprotein cholesterol levels after recent ST-Elevation myocardial infarction was low when patients were prescribed with a lower range of high-intensity statin, reflecting the need for rigorous follow up including monitoring of lipid levels and intensification of statin dose and type as recommended by international guidelines. Keywords: Low-Density Lipoprotein Cholesterol; secondary prevention; statin; statin intensity; ST-Elevation myocardial infarction.Publication Prevalence and Comparision of Conventional Risk Factors of Cardiovascular Disease Between Clinical and Nonclinical Staff(Nepal Health Research Council, 2023) Khadka, Sunita; Dhungana, Suraksha; Prajapati, Dipanker; Dhungana, Murari; Dangol, Prati Badan; Shakya, Roji; Tamrakar, Binita; Kandel, Unnati; Adhikari, Chandra ManiAbstract Background: Cardiovascular disease is the leading cause of death around the globe. A number of studies have shown that hospital staff are vulnerable to cardiovascular disease due to a certain risk of shift duty. It is important to identify cardiovascular risk factors among hospital staff. The aim of this study is, to assess the prevalence of conventional risk factors of cardiovascular disease among hospital staff. Methods: A quantitative cross-sectional study was conducted among staff working at a Shahid Gangalal National Heart Center, a tertiary cardiac center in Nepal. Simple and multiple linear regression analyses were used to examine the association between independent variables and cardiovascular diseases. Statistical analysis was done using SPSS software version 20. Results: A total of 250 hospital staff participated in this study. Among them, 137 were clinical staff and 113 were non-clinical staff. The mean age of clinical staff and the non-clinical staff was 33.69 ± 7.02 years and 38.7 ± 10.58 years respectively with a total of 66.8% females. Prevalence of hypertension, diabetes mellitus, and dyslipidaemia was less in clinical staff compared to non-clinical staff. The mean systolic, diastolic BP was high in non-clinical staff ( P-value 0.001), moreover mean HDL-C was low (1.2 ± 0.2 mmol). BMI was significantly low in clinical staff. [standardized ?= -0.24; 95% CI: -2.90, -0.88]. Conclusions: The prevalence of cardiovascular risk factors were high in non-clinical staff compared to clinical staff. Keywords: Cardiovascular disease; conventional risk factors; hospital staff