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The Association Between Small Dense Low Density Lipoprotein and Coronary Artery Disease in North Indian Patients

Pravin K Goel1, Fauzia Ashfaq1, Roopali Khanna1

  • 1Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Indian Journal of Clinical Biochemistry : IJCB
|April 22, 2017
PubMed

Insights

Small dense low-density lipoprotein (sdLDL) is a more atherogenic particle. This study found higher sdLDL levels in Indian patients with coronary artery disease (CAD), correlating with disease severity.

Area of Science:

  • Cardiology
  • Lipid Metabolism
  • Atherosclerosis Research

Background:

  • Coronary artery disease (CAD) pathogenesis is multifactorial, with LDL-C a known risk factor.
  • Indian populations with CAD often present with normal LDL-C levels, suggesting other lipid factors may be involved.
  • Small dense LDL (sdLDL) particles are considered more atherogenic than larger LDL particles.

Purpose of the Study:

  • To investigate the association between serum sdLDL levels and angiographically confirmed CAD in an Indian population.
  • To determine if sdLDL levels correlate with the severity of coronary artery stenosis.
  • To establish a potential diagnostic threshold for sdLDL in CAD detection.

Main Methods:

  • A cross-sectional case-control study involving 126 CAD patients and 64 controls.
  • Measurement of serum sdLDL using direct quantitative enzymatic analysis.
  • Assessment of traditional lipid profiles (Total Cholesterol, HDL-C, LDL-C, Triglycerides) and CAD severity via Syntax Score.

Main Results:

  • Mean sdLDL levels were significantly higher in patients with CAD (16.3 ± 6.8 mg/dL) compared to controls (10.1 ± 5.7 mg/dL; p < 0.001).
  • A significant positive correlation was observed between sdLDL levels and CAD severity, as indicated by the Syntax Score (p < 0.001).
  • An sdLDL cutoff value of 10.02 mg/dL demonstrated high accuracy in identifying the presence of CAD (p < 0.001).

Conclusions:

  • Indian patients with established CAD exhibit elevated sdLDL levels, even when traditional LDL-C levels are within normal ranges.
  • sdLDL cholesterol is a significant independent risk factor for CAD and correlates with disease severity in this population.
  • sdLDL measurement may offer valuable insights for CAD risk assessment and management, particularly in ethnic groups with differing lipid profiles.

Keywords:
Coronary artery diseaseFasting lipid profileLDL sub fractionsLipid metabolismsdLDL

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