TMSS Medical College Journal

Background: Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. The incidence of AMI is dependent on certain traditional predisposing risk factors. In addition with the traditional risk factors, raised serum calcium level is also being considered as an associated factor for AMI. Objective: The aim of the study is to evaluate the association of serum calcium level with acute myocardial infarction in a tertiary level hospital in Bangladesh. Materials and Methods: A case control study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from January 2013 to December 2013. In this study, 50 diagnosed cases of AMI from DMCH and 50 age and sex matched apparently healthy subjects were selected from DMCH purposively according to the selection criteria. Blood pressure, height and weight were measured and BMI was calculated. Biochemical parameters- serum calcium and fasting blood glucose in two groups were estimated in mmol/L respectively. Then serum calcium was compared between two groups to observe the association with AML. Results were analyzed statistically in SPSS version 17.0. Unpaired student's t-test and Spearman correlation analysis were done. All the results were expressed as mean £SD and p value <0.05 was accepted as level of significance. Results: Present study showed that serum calcium level was significantly higher in cases when compared with that of controls (p=0.001) which was 2.61=0.15 mmol/L and 2.13+0.15 mmol/L in cases and controls respectively. Serum calcium also showed a significant positive correlation with AMI (tho=0.858, p=0.001). Conclusion: Findings of study concludes that increased serum calcium is associated with AMI iin a tertiary level hospital in Bangladesh.

The calcium ion is an essential regulator in many homeostatic systems, including vascular tone, hormone secretion, and intermediary metabolism (Campbell et al., 1983)". Calcium is also essential for nerves, muscles, heart and other body system to work properly. Calcium ion not only plays a role in regulating variety of physiological events, it is also involved in developing pathological condition mainly in heart. Increased level of calcium causes coronary artery and peripheral arteriolar constriction by binding with the heart and smooth muscle through calcium receptor and thus increases cardiac contractility and causes diminished oxygen supply to myocardium. This eventually increases the risk of cardiovascular disease. According to Nadia (2011), increased level of calcium causing abnormality of heart leading to excessively forceful or tight contraction causes increased and irregular heartbeat (tachycardia and arrhythmia). A calcium overload also causes increased blood pressure, coronary artery calcification * 5 and progression of atherosclerosis that involves lipid as well as collagen, elastin and calcium accumulation in coronary vasculature. Myocyte infiltration, endothelial injury, smooth muscle proliferation and migration are also involved in coronary atherosclerosis. Several of these processes are also mediated by calcium ion.