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Risk Factors, biochemical markers, and genetic polymorphisms in early coronary artery disease
Maria Cristina Izar1, Francisco Antonio Helfenstein Fonseca, Sílvia Saiuli Miki Ihara
1Disciplina de Cardiologia, UNIFESP/EPM, Universidade Federal de São Paulo, Sao Paulo, SP. lipides.dmed@unifesp.epm.br
Insights
Hypertension and diabetes are key risk factors for early coronary artery disease (CAD). This study found an unfavorable lipid profile and increased thrombotic risk in patients with early CAD, with APO AI-CIII gene variants affecting triglyceride levels.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Biochemistry
Background:
- Early coronary artery disease (CAD) poses a significant health burden.
- Understanding risk factors and genetic predispositions is crucial for prevention and management.
Purpose of the Study:
- To investigate risk factors, lipid/apolipoprotein profiles, hemostasis, and apolipoprotein AI-CIII gene polymorphisms in early CAD.
- To identify independent risk factors and their association with lipid profiles and thrombotic markers.
Main Methods:
- A case-control study involving 112 patients with early CAD and 112 controls, matched for sex and age.
- Clinical evaluation, nutritional counseling, and biochemical assays including lipid profiles, apolipoproteins, and hemostasis variables.
- Genetic analysis of apolipoprotein AI-CIII gene polymorphisms.
Main Results:
- Hypertension, diabetes mellitus, familial history of early CAD, and smoking were more prevalent in the early CAD group.
- Independent risk factors identified were hypertension and diabetes mellitus.
- Early CAD patients exhibited higher total cholesterol, LDL-c, triglycerides, apolipoprotein B, fibrinogen, and D-dimer, with lower HDL-c and apolipoprotein AI.
- APO AI-CIII gene variants were associated with hypertriglyceridemia.
Conclusions:
- Hypertension and diabetes mellitus are independently associated with early CAD.
- Early CAD is characterized by an unfavorable lipid profile and elevated thrombotic risk.
- APO AI-CIII gene polymorphisms have an additive effect on triglyceride levels.
Objective:
To assess the risk factors, lipid and apolipoprotein profile, hemostasis variables, and polymorphisms of the apolipoprotein AI-CIII gene in early coronary artery disease (CAD).
Methods:
Case-control study with 112 patients in each group controlled by sex and age. After clinical evaluation and nutritional instruction, blood samples were collected for biochemical assays and genetic study.
Results:
Familial history of early CAD (64 vs 39%), arterial hypertension (69 vs 36%), diabetes mellitus (25 vs 3%), and previous smoking (71 vs 46%) were more prevalent in the case group (p<0.001). Hypertension and diabetes were independent risk factors. Early CAD was characterized by higher serum levels of total cholesterol (235 +/-6 vs 209 +/- 4 mg/dL), of LDL-c (154 +/- 5 vs 135 +/- 4 mg/dL), triglycerides (205 +/- 12 vs 143 +/- 9 mg/dL), and apolipoprotein B (129 +/- 3 vs 105 +/- 3 mg/dL), and lower serum levels of HDL-c (40 +/- 1 vs 46 +/- 1 mg/dL) and apolipoprotein AI (134 +/- 2 vs 146 +/- 2mg/dL) [p<0.01], in addition to an elevation in fibrinogen and D-dimer (p<0.02). The simultaneous presence of the rare alleles of the APO AI-CIII genes in early CAD are associated with hypertriglyceridemia (p=0.03).
Conclusion:
Of the classical risk factors, hypertension and diabetes mellitus were independently associated with early CAD. In addition to an unfavorable lipid profile, an increase in the thrombotic risk was identified in this population. An additive effect of the APO AI-CIII genes was observed in triglyceride levels.