Young & active? Vitamin shortage may still hit heart

Mumbai: With his unkempt mop of hair and lanky frame, Airoli resident Pravin Joshi seemed out of place in a cardiac intensive care unit. Barely 29 and recently married, the software professional was rushed to Hiranandani Hospital at Powai on a Sunday morning for an immediate angioplasty. Cardiologist Ganesh Kumar had barely placed a stent in Joshi's artery when another heart attack victim was wheeled in. This time, it was a 31-year-old call centre employee, 

Sunil Misra. 
    Neither Joshi nor Misra have had any of the usual risk factors connected to heart diseases: diabetes, hypertension and high levels of cholesterol (fat). But Dr Kumar found through various tests that both lacked certain proteins. "They had elevated levels of Lipoprotein (a) or Lp(a),'' said the doctor, who then asked long-time patients to test their Lp(a) levels. 
    Now, doctors in Mumbai are using diagnostic tests more effectively to explore hitherto ignored reasons for heartailments. Not only do the tests help in identifying crucial indicators of heart attacks, but could perhaps assist in finding out who could be prone to them. Dr A B Mehta, director of cardiology at Jaslok Hospital, said, "Doctors are certainly using more blood tests to establish the major or minor reasons for heart problems." 
    The drill is simple: If a patient has high homocysteine levels, he or she has a relatively minor risk of suffering from a heart disease. "If the LDL (bad cholesterol) is high and HDL (good cholesterol) is low, we know the patient has a high risk," said Dr Mehta. Doctors are also closely studyingLp(a)—a type of protein that is usually higher in patients with coronary artery disease. 
    The sudden interest in Lp (a) is due to the fact that these cardiac caregivers can, for the first time, offer a treatment of sorts—a new, upgraded version of Vitamin B3. 
    Vitamin B3, called niacin, is not a newcomer in the pharma shelves, but has been sparingly prescribed because of its side-effects. "Patients would experience flushing (an increase in blood flow),'' said Dr Mehta. But a couple of months ago, a multinational company introduced a version of niacin that doesn't lead to flushing.