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Biochemical risk factors for cardiovascular disease in an aged male population: emerging vascular pathogens
1Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Biomediche e Morfologiche, Università degli Studi di Verona, Italy.
Insights
Elevated levels of lipoprotein(a) and homocysteine are key indicators of cardiovascular disease (CVD) risk in elderly men. These emerging markers, alongside traditional lipids, improve risk assessment for acute myocardial infarction and peripheral occlusive disease.
Area of Science:
- Cardiology
- Biochemistry
- Preventive Medicine
Background:
- Cardiovascular disease (CVD) poses a significant global health challenge, necessitating effective preventive strategies.
- Current diagnostic guidelines and risk assessment panels for CVD may be insufficient and require updates.
- Elderly male populations are particularly vulnerable to CVD, including acute myocardial infarction (AMI) and peripheral occlusive disease (POD).
Purpose of the Study:
- To evaluate a comprehensive cardiovascular risk profile in elderly male patients diagnosed with AMI or POD.
- To compare emerging biomarkers like lipoprotein(a) (Lp[a]), homocysteine (Hcy), and C-reactive protein (CRP) with conventional lipid profiles.
- To identify key predictors of AMI and POD in this demographic.
Main Methods:
- Serum levels of triglycerides, total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), Lp[a], Hcy, and CRP were measured.
- Patient data were compared against a control group of healthy individuals.
- Multivariate regression analysis was employed to determine the predictive value of different biomarkers for AMI and POD.
Main Results:
- Patients with AMI and POD showed significantly higher concentrations of triglycerides, Lp[a], Hcy, and the TC/HDL ratio compared to controls.
- Lower plasma HDL levels were observed in patients with CVD.
- Lp[a] and Hcy were identified as the strongest predictors for AMI, while Lp[a], Hcy, and the TC/HDL ratio predicted POD.
Conclusions:
- Elevated Lp[a] and Hcy levels play a crucial role in the development of atherosclerotic disease in elderly men.
- Incorporating Lp[a], Hcy, and the TC/HDL ratio into cardiovascular risk assessment panels can enhance preventive strategies.
- These findings support the revision of current CVD risk evaluation tools to include novel biomarkers for more effective prevention.
Abstract:
The progressive increase of deaths and morbidity from cardiovascular disease (CVD) in most developed societies has led to the formulation of preventive strategies and application of several diagnostic guidelines. However, there is emerging evidence that most panels and algorithms are inadequate and require urgent revision and updating. Therefore, the aim of this study was the evaluation of a wide cardiovascular risk profile in elderly male patients with acute myocardial infarction (AMI) or peripheral occlusive disease (POD). The risk profile was assessed by measuring conventional serum lipid and lipoprotein levels and emerging parameters: lipoprotein(a) (Lp[a]), homocysteine (Hcy), and C-reactive protein (CRP). The concentration of triglycerides, Lp(a), Hcy and the total cholesterol/high-density lipoprotein (TC/HDL) ratio were significantly higher in both classes of patients than in a population of matched healthy controls and, similarly, patients with CVD displayed lower plasma values of HDL. No significant differences were observed for TC, low-density lipoprotein (LDL), and CRP. Patients with POD exhibited a marked atherogenic profile, as attested by substantially increased values of Hcy, Lp(a), triglycerides, and TC/HDL ratio. The frequency distributions of Lp(a) and Hcy concentrations were markedly shifted toward upper values in both classes of patients than in controls. In multivariate regression analysis, Lp(a) and Hcy were the best predictors for AMI, whereas Lp(a), Hcy, and the TC/HDL ratio were the best predictors for POD. Taken together, these data suggest that Lp(a) and Hcy excesses might exert a central role in the development of atherosclerotic disease in elderly male patients. Thereby, the inclusion of those tests, along with the TC/HDL ratio and other more conventional analyses in panels for the evaluation of the cardiovascular risk might be profitable in terms of effectual prevention.