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Predictors of atherosclerosis.

Yasuhiko Homma1

  • 1Health Evaluation and Promotion Center, Tokai University Hospital, Kanagawa, Japan. homma@is.icc.u-tokai.ac.jp

Journal of Atherosclerosis and Thrombosis
|November 24, 2004
PubMed
Summary

Predicting coronary artery disease risk requires measuring apolipoprotein B (apoB), apolipoprotein AI (apoAI), remnant-like particle cholesterol (RLP-C), lipoprotein (a) [Lp(a)], and high-sensitivity C-reactive protein (hs-CRP) alongside traditional lipids.

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Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Preventive Cardiology

Background:

  • Traditional lipid profiles (LDL-C, HDL-C) have limitations in predicting coronary artery disease (CAD).
  • Emerging biomarkers like apolipoproteins, remnant lipoproteins, oxidized LDL, Lp(a), metabolic syndrome, and hs-CRP show promise.
  • Current clinical practice needs enhanced risk evaluation tools for atherosclerosis.

Purpose of the Study:

  • To identify optimal plasma biomarkers for predicting atherosclerosis.
  • To enhance the predictive power of coronary risk evaluation in clinical practice.
  • To propose a new atherosclerosis risk scoring system.

Main Methods:

  • Review of existing literature on atherosclerosis predictors.
  • Analysis of the clinical utility of various plasma markers including apoB, apoAI, TG, HDL-C, ox-LDL, Lp(a), MS components, and hs-CRP.
  • Consideration of practical implementation in routine clinical examinations.

Main Results:

  • Apolipoprotein B (apoB) and apoAI are superior CAD predictors compared to LDL-C and HDL-C.
  • Plasma levels of remnant-like particle cholesterol (RLP-C), lipoprotein (a) [Lp(a)], and high-sensitivity C-reactive protein (hs-CRP) are significant risk factors.
  • Estimating small, dense LDL indirectly via triglyceride (TG), apoB, and HDL-C is a practical approach.

Conclusions:

  • Plasma apoB, apoAI, RLP-C, Lp(a), and hs-CRP, in addition to lipids, should be measured for atherosclerosis prediction.
  • A new, comprehensive atherosclerosis risk evaluation scoring system is needed, based on large-scale prospective studies.
  • Japan's routine measurement of Lp(a), RLP-C, and hs-CRP facilitates the development of such a system.

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