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Lipoprotein(a) and coronary heart disease in Indian population
S Singh1, S Dwivedi, G C Melkani
1Central Drug Research Institute, Lucknow-226 001, India.
Insights
Elevated lipoprotein(a) levels are significantly associated with coronary heart disease (CHD) risk in patients. Measuring lipoprotein(a) and albumin accurately identifies individuals with CHD, highlighting their clinical importance.
Area of Science:
- Cardiovascular Medicine
- Clinical Biochemistry
- Lipidology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Lipoprotein(a) [Lp(a)] is an emerging risk factor for atherosclerotic cardiovascular disease.
- Understanding the role of Lp(a) in CHD pathogenesis is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between serum lipoprotein(a) levels and coronary heart disease (CHD).
- To explore the relationship between Lp(a) and established cardiovascular risk factors.
- To assess the discriminatory power of Lp(a) in identifying CHD patients.
Main Methods:
- Serum samples from 222 CHD patients and 67 controls were analyzed.
- Lipoprotein(a) levels were quantified using enzyme-linked immunosorbent assay (ELISA).
- Step-wise linear discriminant analysis was employed to identify key discriminators between CHD and non-CHD subjects.
Main Results:
- CHD patients exhibited significantly higher LDL to HDL cholesterol ratio and serum Lp(a) levels (p < 0.01).
- Lp(a) levels were notably higher in females than males (p < 0.01).
- Lp(a) levels were elevated in CHD patients with a family history of NIDDM and hypertension.
Conclusions:
- Serum Lp(a) and albumin levels are clinically significant in assessing CHD risk.
- Lp(a) alone achieved 95% discrimination between CHD and control subjects.
- Combined measurement of Lp(a) and albumin provided 99% discrimination, underscoring their diagnostic utility.
Objective:
Present study was undertaken to evaluate the role of lipoprotein(a) in coronary heart disease (CHD) patients and its relationship with other established risk factors.
Methods:
Blood samples of 67 control patients (non-cardiovascular problems) and 222 CHD patients (> or = 4 weeks post myocardial infarction) were analyzed. Lipoprotein(a) was measured in serum samples by enzyme-linked immunosorbent assay utilizing rabbit polyclonal antibodies against purified human Lp(a). Step-wise linear discriminant analysis was used to find the important parameters to discriminate CHD and non-CHD subjects.
Results:
The LDL to HDL cholesterol ratio (p < 0.01) and serum level of lipoprotein(a) (p < 0.01) were significantly higher in CHD patients. Levels of lipoprotein(a) were found to be higher in females compared to males (p < 0.01). Positive family history of CHD did not show significant difference in Lp(a) levels. Lp(a) level in CHD patients with positive family history of NIDDM and hypertension was higher than in with negative family history.
Conclusion:
Clinical significance of serum level of Lp(a) and albumin in determining the risk of CHD has been observed. Lp(a) alone could correctly discriminate a CHD individual from a control subjects by 95%. Estimating of Lp(a) together with albumin provided 99% correct discrimination between control and CHD patients. These results also suggest that Lp(a) together with malnutrition could be responsible for the increased incidence of CHD in Indians. It is also indicated that in females atherothrombogenic potential of lipoprotein(a) remains suppressed before menopause but after this stage women lose this advantage.