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Plasma apoproteins and the severity of coronary artery disease
Insights
The ratio of apoprotein AI to apoprotein B better predicts coronary artery disease (CAD) severity than traditional lipid levels. This finding holds true even after accounting for other risk factors in men.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Diagnostics
Background:
- Coronary artery disease (CAD) is a leading cause of mortality.
- Lipid and lipoprotein levels are established risk factors for CAD.
- Apoproteins, components of lipoproteins, may offer additional predictive value.
Purpose of the Study:
- To compare the predictive power of apoprotein ratios versus lipid ratios for CAD presence and severity.
- To investigate the independent effect of apoprotein ratios on CAD severity.
Main Methods:
- Correlated plasma apoprotein and lipid levels with CAD incidence and severity in 281 patients undergoing cardiac catheterization.
- Utilized multivariate analysis to adjust for confounding factors.
- Compared apoprotein AI/B ratio with high-density to low-density lipoprotein ratios.
Main Results:
- The apoprotein AI to apoprotein B ratio was the only variable besides age correlating with CAD severity in men (r = .1908, p < .03).
- Apoprotein AI/B ratio was a more accurate predictor of CAD severity than the corresponding high-density to low-density lipoprotein ratio.
- Apoprotein E and B levels were higher in men with total coronary occlusion.
Conclusions:
- Apoprotein ratios, particularly apoprotein AI/B, are valuable predictors of CAD severity in men.
- Apoprotein levels provide independent predictive information beyond traditional lipid profiles.
- Further research is needed to explore gender-specific differences in lipid profiles and CAD.
Abstract:
Plasma levels of lipids, lipoproteins, and apoproteins in 281 patients undergoing cardiac catheterization were correlated with the incidence and severity of coronary artery disease (CAD) to determine if measurements of apoprotein levels are more predictive of the presence and severity of CAD than the corresponding levels of lipoprotein lipids. In 156 men with CAD among 194 men in the study the only variable other than age that correlated with the severity of CAD, defined by the number of lesions and percent stenosis, was the ratio of apoprotein AI to apoprotein B (r = .1908, p less than .03). The ratio of apoprotein AI to apoprotein B was a more accurate predictor of the severity of CAD than was the ratio of the corresponding high-density to low-density lipoprotein levels (coefficients of partial determination of .07 and .035; p less than .001 and p less than .07, respectively). Multivariate analysis confirmed the independent effect of the ratio of apoprotein AI to apoprotein B on the severity of CAD even after adjustments were made for lipid levels, age, presence of hypertension or diabetes, and therapy with beta-blockers or diuretics. Among men with total occlusion of a coronary artery apoprotein E and apoprotein B levels were significantly higher than in control subjects with a similar extent of CAD (p less than .03). The lipid profiles of the 37 women with CAD were very different from those of the men.(ABSTRACT TRUNCATED AT 250 WORDS)