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[Predictive value of lipoprotein (a) and apolipoprotein A1 in patients with angiographycally evaluated coronary
José Domingo Sagastagoitia1, Marta Vacas, Yolanda Sáez
1Servicio de Cardiología, Hospital de Basurto, Departamento de Medicina, Universidad del País Vasco UPV/EHU, Bilbao, Vizcaya, España. bdbvarim@lg.ehu.es
Insights
High lipoprotein (a) levels are linked to coronary artery obstruction, while high apolipoprotein A1 levels appear protective. This study analyzed lipids, hemostatic, and inflammatory markers in patients with chest pain.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Medicine
Background:
- Coronary artery stenosis is a major cause of cardiovascular disease.
- Lipid, hemostatic, and inflammatory markers are implicated in atherosclerosis.
- Understanding these associations can aid in risk stratification.
Purpose of the Study:
- To investigate the relationship between blood levels of various biomarkers and the presence of coronary artery stenosis.
- To identify specific markers associated with coronary obstruction in patients presenting with chest pain.
Main Methods:
- A cohort of 397 patients with acute chest pain underwent coronary angiography.
- Blood samples were analyzed for lipids, hemostatic markers (fibrinogen, D-dimer), and inflammatory markers (C-reactive protein, leukocyte count).
- Logistic regression analysis was used to determine the association between marker levels and coronary obstruction.
Main Results:
- Patients with coronary stenosis (295) exhibited higher lipoprotein (a), D-dimer, C-reactive protein, and leukocyte counts, along with lower HDL cholesterol and apolipoprotein A1.
- High lipoprotein (a) levels were significantly associated with coronary obstruction (OR = 2.508).
- High apolipoprotein A1 levels demonstrated a protective association (OR = 0.472).
Conclusions:
- Elevated lipoprotein (a) levels are an independent risk factor for coronary obstruction.
- Higher apolipoprotein A1 levels appear to have a protective effect against coronary artery disease.
- These findings highlight the potential role of lipoprotein (a) and apolipoprotein A1 in assessing coronary artery disease risk.
Background And Objective:
To examine the relationship between blood levels of lipids, hemostatic and inflammatory markers and the presence of angiographycally evaluated coronary stenosis.
Patients And Method:
We included 397 consecutive patients (267 males and 130 females) who were admitted to the hospital because of an acute episode of chest pain. Each patient underwent a coronariography using the Seldinger technique. A blood sample was drawn to analyze lipids -total cholesterol, high density lipoproteins-cholesterol (HDLc), triglycerides, low density lipoproteins-cholesterol (LDLc), apolipoprotein A1, apolipoprotein B100, lipoprotein (a)-, hemostatic (fibrinogen, D-dimmer), and inflammatory (C-reactive protein, leukocyte count) markers. To evaluate the differences between mean values of quantitative variables, the Student's t-test was used for parametric variables and the Mann Whitney U test for non-parametric variables. Categorical variables were compared using the chi-square test. A logistic regression analysis was employed to determine the influence of high levels of the studied parameters on the presence of coronary obstruction.
Results:
295 patients had coronary stenosis (group 1) and 102 had not a significant obstruction (group 2). Patients with coronary stenosis had higher values of lipoprotein (a), D-dimmer, C-reactive protein and leukocyte count and lower HDLc, apolipoprotein A1 and total cholesterol. When markers were dichotomized in high values (fourth quartile) and low (first-third quartile), high lipoprotein (a) (odds ratio [OR] = 2.508; 95% confidence interval [CI], 1.222-5.145) and apolipoprotein A1 levels (OR = 0.472; 95% CI, 0.267-0.837) were significant using the multivariate logistic regression model adjusted sex, tobacco and age.
Conclusions:
Among patients undergoing coronary angiography, high lipoprotein (a) levels are independently associated with the presence of coronary obstruction whereas high apolipoprotein A1 values show a protective effect.
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