Dyslipoproteinemia and coronary disease

Dyslipoproteinemia is involved in the origin of arteriosclerosis by changing the architecture of the coronary artery wall and therefore represents an important factor in the development of coronary artery disease (CAD). High-density lipoprotein (HDL) and apolipoprotein-A1 (Apo A1) serve as protection against the origin and development of coronary obstructive disease. The aims of this study were to evaluate the relations among the plasma lipids, their fraction Apo A1, HDL, and positive coronary arteriography, and to estimate their importance as markers of the degree of coronary lesions. The study included 101 subjects, 77 men and 24 women, aged 35 to 75 years, mean age = 55.7 years. The subjects were divided into 2 groups: 1 group--CAD with positive coronary arteriography (n = 70), and the other group--CAD with negative coronary arteriography (n = 31). According to the anatomic localization of atherosclerotic lesion, the first group of subjects was divided into 1-vessel (n = 26), 2-vessel (n = 20), and multiple-vessel lesion (n = 24) subgroups. The results show a significant difference in Apo A1 and Apo A1/Apo B (p<0.005) in the 2- and multiple-vessel disease in relation to the control group, while subject significance was not proved for 1-vessel disease. A positive correlation and significance for HDL as well as cholesterol ratio/HDL (p<0.05) was noted for 1- and multiple-vessel disease, while a negative correlation was noted for 2-vessel disease in relation to the control group. This study stressed the diagnostic significance in determining Apo A1 and Apo A1/Apo B1 as better predictors than HDL cholesterol in evaluating coronary lesion severity. Dyslipoproteinemia, namely, the level of lipoproteins of low density, plays an important role in the pathogenesis of arteriosclerosis and the development of CAD.