The aim of this study was to provide an overview of the risk factors for acute myocardial infarction in patients attending Tripoli Medical Centre, Libya. Records were reviewed for 622 patients with a mean age of 58.3 (SD 12.9) years. Diabetes mellitus (48.2%), hypertension (35.7%) and smoking (50.6%) were among the risk factors reported. There were 110 patients (17.7%) who died during hospitalization, mainly suffering cardiogenic shock (48.0%). The rate of use of thrombolytic therapy was low in patients who were female (40.4% versus 58.4% for males), older age (31.6% for those > 85 years versus 63.3% for patients < 55 years), diabetics (45.3% versus 62.0% for non-diabetic patients) and hypertensives (47.3% versus 57.8% for non-hypertensive patients). Prevention strategies should be implemented in order to improve the long-term prognosis and decrease overall morbidity and mortality from coronary artery disease in Libyan patients.

Background: The metabolic syndrome (MS) is defined as a cluster of cardiovascular risk factors, including central obesity, dysglycemia, hypertension (HPN), elevated triglycerides (TGs), and reduced high-density lipoprotein cholesterol (HDL-C). MS increases the risk of cardiovascular disease and all-cause mortality. Objective: This study aims to estimate the prevalence of MS and its components among nondiabetic Libyan females using the definition proposed by National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Methods: A total of 122 randomly selected nondiabetic Libyan females were included in the study. Detailed medical history was obtained from all participants. Blood pressure, weight, height, waist and hip circumference were measured. Body mass index and waist–hip ratio were calculated. Fasting blood glucose (FBG) and lipid profile were collected. Standard oral glucose tolerance test with 75 GM glucose was performed. The MS was defined by ATP III and International Diabetes Federation criteria. Results: According to NCEP definition, the prevalence of the MS in the study group was 42.6%. The most common component was abdominal obesity (67.2%). FBG was ≥ 100 mg/dl in 47.5%. The prevalence of both HPN and low HDL-C was 45.9%. About 26.2% of the participants have their TG ≥ 150 mg/dl; all were MS patients. Conclusions: The prevalence of MS and cardiovascular risk factors were high among Libyan females. Public health authorities and health-care providers should implement strategies for prevention, screening, and management of cardiovascular risk factors to reduce the burden of its potential complications.

Diabetes imposes high economic and social costs on countries at all income levels. The estimated number in 2013 of diabetic patients was 382 million and is expected to increase by 55% by 2035. [1] The burden of diabetes is mounted, by its complications. It is the leading cause of lower-limb amputation, renal failure, and blindness. The control of associated cardiovascular risk factors and modification of lifestyle habits constitute an integral part of diabetes management, to prevent complications. [2] Smoking is a major modifiable risk factor for premature mortality. It shortens the lifespan, on average, by 10 years, and cessation before the age of 40 years decreases that loss by about 90%. [3] The rate of death from any cause among current smokers is about three times as high as among persons who never smoked. [4] Even in patients without diabetes, urinary albumin, a marker of potential renal damage, and cardiovascular mortality increases in a dose-dependent manner with the number of cigarettes smoked per day. [5] In diabetic patients, smoking increases the risk of stroke by 30%, myocardial infarction 1.4 fold and progression to end-stage renal disease (ESRD). [6,7] Data from Libya indicate a high prevalence of cigarette smoking among high-risk diabetic patients. A study evaluating the prevalence of risk factors in acute myocardial infarction patients admitted to the coronary care unit of Tripoli Medical Center (TMC), Libya has shown a high prevalence of current smokers 62.6%, and diabetes mellitus (DM) (42.9%), among admitted Libyan male patients. [8] In a systematic review of ten epidemiological studies, diabetic kidney disease was the leading cause of dialysis-treated (ESRD) among Libyans, the prevalence and incidence of diabetic kidney disease were 26.5% and 28.4%, respectively. [9] In a retrospective study of 5 years mortality among ESRD patients undergoing maintenance hemodialysis, diabetic nephropathy was the underlying cause in 27.4% of patients, with a mortality rate of 74.1%. The prevalence of cigarette smoking among diabetic patients was 23.3% and was associated with increased mortality risk. [10] Introduction: Smoking is a major avoidable cardiovascular risk factor and is a cause of premature death worldwide. Objectives: To study the prevalence, pattern, and awareness of health hazards of smoking among Libyan diabetic male patients in Tripoli Medical Center,

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Background: Patients with coronary artery disease (CAD) frequently have multiple risk factors. Diabetes and impaired glucose tolerance (IGT) have been associated with cardiovascular events and cardiovascular disease mortality. Aim of the study: This study aims to determine the prevalence of abnormal glucose regulation (AGR) among Libyan patients, presenting for elective coronary angiography. Methods: All patients referred for a diagnostic coronary angiogram at the Catheterization Laboratory of National Heart Centre, Tajora, Tripoli, over a period of 1 year from April 2007 to March 2008, were included after consent. Patients with a history of diabetes were excluded from the study. Diagnostic coronary angiogram was performed for all included patients as well as a standard oral glucose tolerance test (OGTT) with 75 GM glucose. Results: Ninety-nine patients were included in our study, with a mean age of 54.6 ± 11.2 years. 49 (49.5%) of the enrolled patients showed either impaired or diabetic fasting or 2-h OGTT results. 22 (22.2%) patients were diabetic based on fasting blood glucose or 2-h OGGT result, and 21 (21.2%) have IGT. Of the 15 (15.2%) patients with impaired fasting glucose, 7 (46.7%) patient showed diabetic glucose tolerance, and 2 (13.3%) patients have IGT. Among patients with AGR, coronary angiogram showed significant CAD in 36 (73.5%), compared to 28 (56%) of patients with normal fasting and 2-h OGTT results. Conclusion: Abnormal glucose regulation was high among Libyan patients presented for elective angiography. OGTT should be part of the evaluation in this high-risk population.

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Subclinical hypothyroidism (SCH) is a biochemical condition characterized by high serum thyroid stimulating hormone (TSH), with normal levels of thyroid hormones and without overt clinical features of hypothyroidism.Thyroxine replacement therapy is reasonable for patients with a TSH greater than 10 mU/L because the rate of progression to overt hypothyroidism is up to 5% per year in comparison with lower TSH levels.For patients with a mild degree of SCH (TSH ≤ 10 mU/L) thyroxine replacement therapy is recommended if they have symptoms, goiter, anti-TPO antibodies or infertility and in pregnant patients.This review discusses the risks and/or benefits of thyroxine replacement treatment of subclinical hypothyroidism for those patients with a serum TSH level of 4.5-10.0 mIU/L.