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Comparison of serum lipid values in variant angina pectoris and fixed coronary artery disease with normal subjects
H Tasaki1, Y Nakashima, H Nandate
1Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu.
Insights
Apolipoprotein AI (apo AI) levels can help distinguish variant angina and coronary artery disease (CAD) patients from healthy individuals. Low apo AI levels in symptomatic patients warrant further investigation for these conditions.
Area of Science:
- Cardiology
- Clinical Biochemistry
- Atherosclerosis Research
Background:
- Variant angina and coronary artery disease (CAD) involve complex lipid and apolipoprotein profiles.
- Understanding these profiles aids in differentiating cardiac conditions.
Purpose of the Study:
- To compare lipid and apolipoprotein levels in patients with variant angina, fixed CAD, and healthy controls.
- To identify apolipoproteins that effectively discriminate between these groups.
Main Methods:
- Measured plasma lipids and apolipoproteins in 108 men (22 variant angina, 56 fixed CAD, 30 controls).
- Utilized stepwise discriminant analysis to identify key discriminatory markers.
- Coronary angiography was performed on 90 participants.
Main Results:
- Apolipoprotein AI (apo AI) was the most effective discriminator between groups.
- Significantly decreased levels of high-density lipoprotein cholesterol, apo AI, and apo AII were observed across groups.
- Apo AI levels of 135 mg/dl and 126 mg/dl accurately differentiated variant angina and fixed CAD from controls, respectively.
Conclusions:
- Apo AI levels are valuable in distinguishing patients with variant angina and fixed CAD from normal subjects.
- Low apo AI levels in symptomatic individuals necessitate thorough cardiovascular examination.
Abstract:
Lipid and apolipoprotein (apo) levels in patients with variant angina were examined and compared with patients with coronary artery disease (CAD) and normal subjects (control). Cholesterol and triglyceride levels in plasma, lipoprotein fractions and several apolipoproteins were measured in 108 men (90 of whom had undergone coronary angiography): 22 had variant angina, 56 had fixed CAD (effort angina and old myocardial infarction) and 30 were normal subjects. Patients with variant angina showed more severe atherosclerotic lesions than the control group, but less severe lesions than the patients with fixed CAD. In comparison with lipid and apolipoprotein, high density lipoprotein cholesterol, apo AI and apo AII decreased significantly in control, variant angina and fixed CAD groups, respectively. Additionally, stepwise discriminant analysis revealed that apo AI was the best discriminator among the 3 groups or between variant angina or fixed CAD and the control group. Variant angina and fixed CAD patients could be discriminated from the control subjects by an apo AI level of 135 and 126 mg/dl, with 71% (p less than 0.025) and 73% (p less than 0.005) accuracy, respectively. By these criteria 77% of the patients with variant angina and 73% of the patients with fixed CAD were precisely discriminated. Discrimination between variant angina and fixed CAD patients, however, was not practical, even if the best discriminator was used. Thus, the apo AI level is useful in discriminating patients with variant angina and fixed CAD from normal subjects. Therefore, symptomatic patients with low apo AI levels should be aggressively examined.