Lipoprotein (A): Better assessor of coronary heart disease risk in south Indian population
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Published on: October 12, 2017
D Rajasekhar1, K S S Saibaba, P V L N Srinivasa Rao
1Department of Cardiology, Sri Venkatesware Institute of Medical Sciences, 517507 Tirupati, India.
Insights
Lipoprotein (a) (Lp(a)) is linked to coronary heart disease (CHD) risk in India. Elevated Lp(a) levels, particularly above 25 mg/dl, indicate a higher likelihood of developing CHD.
Area of Science:
- Cardiology
- Biochemistry
- Public Health
Background:
- Coronary heart disease (CHD) prevalence is rising in the Indian population.
- Identifying novel risk factors is crucial for understanding and mitigating CHD.
- Lipoprotein (a) (Lp(a)) is a potential, yet under-researched, contributor to cardiovascular risk.
Purpose of the Study:
- To investigate the association between Lipoprotein (a) (Lp(a)) levels and Coronary Heart Disease (CHD) in the Indian population.
- To determine if Lp(a) can serve as a predictive biomarker for CHD risk.
- To explore the relationship between Lp(a) and the severity of coronary artery disease.
Main Methods:
- A case-control study was conducted with 151 CHD patients and 49 healthy controls.
- Measurements included triglycerides, cholesterol ratios (total-C/HDL-C, LDL-C/HDL-C), and Lipoprotein (a) (Lp(a)).
- Statistical analyses assessed correlations between Lp(a) levels, CHD presence, and disease severity.
Main Results:
- Patients with CHD exhibited higher levels of triglycerides, VLDL-C, cholesterol ratios, and Lp(a) compared to controls.
- Higher Lp(a) levels correlated positively with increased coronary artery disease severity (triple vessel disease).
- Lp(a) levels exceeding 25 mg/dl were significantly associated with CHD (Odds ratio 1.98, P<0.05).
Conclusions:
- A Lipoprotein (a) (Lp(a)) cut-off level of 25 mg/dl is suggested for determining Coronary Heart Disease (CHD) risk.
- Lp(a) emerges as a significant risk factor for CHD in the Indian population.
- Further large-scale studies are recommended to validate these findings and establish Lp(a) as a clinical marker.
Abstract:
In an attempt to search for risk factors which can explain the increasing prevalence of coronary heart disease (CHD) in Indian population, we conducted a case-control study to assess the association of Lipoprotein (a)(Lp(a)) with CHD. One hundred and fifty one consecutive patients with clinical and angiographic evidence of CHD and forty-nine healthy controls were drawn for the study. Triglycerides, very low density cholesterol (VLDL-C), total cholesterol (total-C)/high density cholesterol (HDL-C) ratio, low density cholesterol (LDL-C)/HDL cholesterol ratio and Lp(a) were found to be higher in patients than controls. In female sex and in those with family history of CHD, higher total and LDL cholesterol levels were observed to be associated with higher Lp(a) levels. Lp(a) levels were also found to be higher in triple vessel disease than other vessel disease patients. Significant difference in Lp(a) levels were observed between normal coronaries vs. single and triple vessel disease(P<0.05) and also between single vs. double and triple vessel disease (P<0.01).Lp(a) levels correlated positively with vessel severity(P<0.005). Lp(a) levels >25 mg/dl were associated with coronary heart disease (Odds ratio 1.98 P<0.05 95% CI 0.007-1.18). Our findings suggest a cut-off level of 25mg/dl for determination of risk of CHD. Studies from different areas involving larger sample size are needed to confirm the findings of the present study.
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