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Low-density lipoprotein-associated variables and the severity of coronary artery disease: an untreated Chinese cohort

Xi Zhao1, Di Sun1, Rui-Xia Xu1

  • 1a Division of Dyslipidemia , State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , PR China.

Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
|May 8, 2018
PubMed

Insights

Small dense LDL (sd-LDL) and oxidized LDL (ox-LDL) better predict coronary artery disease (CAD) severity than other LDL-related variables. These markers, along with apolipoprotein B (apoB), non-HDL-C, LDL-C, and Lp(a), are valuable for assessing CAD risk.

Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Clinical Chemistry

Background:

  • Elevated low-density lipoprotein cholesterol (LDL-C) is a known risk factor for coronary artery disease (CAD).
  • Several LDL-associated variables, including LDL-C, apolipoprotein B (apoB), non-high-density lipoprotein cholesterol (non-HDL-C), lipoprotein a [Lp(a)], small dense LDL (sd-LDL), and oxidized LDL (ox-LDL), are used to predict CAD risk.

Purpose of the Study:

  • To compare the predictive values of six LDL-related variables for assessing the severity of CAD in untreated patients.
  • To evaluate the associations between these variables and CAD severity.

Main Methods:

  • 1977 individuals were enrolled and categorized into CAD (n=1151) and non-CAD (n=826) groups based on coronary angiography (CAG) results.
  • Measurements included LDL-C, apoB, non-HDL-C, Lp(a), sd-LDL, and ox-LDL.
  • CAD severity was assessed using the number of stenotic arteries and Gensini Scores (GS).

Main Results:

  • CAD patients exhibited significantly higher concentrations of all measured LDL-related variables compared to non-CAD individuals (p < 0.05).
  • All variables demonstrated a positive correlation with increasing CAD severity.
  • The predictive value for CAD severity was ranked as: sd-LDL > ox-LDL > apoB > non-HDL-C > LDL-C > Lp(a), with area under the curve (AUC) values ranging from 0.554 to 0.641.
  • Multivariate analysis identified all variables as independent risk factors for CAD severity, with ox-LDL and sd-LDL showing the highest odds ratios (OR).

Conclusions:

  • All six LDL-related variables serve as useful markers for predicting CAD severity.
  • sd-LDL and ox-LDL demonstrated superior predictive capabilities compared to other tested variables.
  • Further research is recommended to validate these findings.
Abstract

Keywords:
Coronary artery diseaseGensini scoreslow-density lipoprotein cholesterolmarker

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