Related Experiment Videos
High prevalence of hypertriglyceridaemia and apolipoprotein abnormalities in coronary artery disease
1Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Insights
This study reveals that high triglyceride levels and abnormal apolipoprotein A-I and B concentrations are common in men with coronary artery disease, even those with normal lipid levels. These findings highlight their significance as risk factors.
Area of Science:
- Cardiovascular Medicine
- Clinical Biochemistry
- Lipid Metabolism
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Lipid profiles and apolipoprotein levels are established markers for cardiovascular risk.
- Abnormalities in serum lipids and apolipoproteins may contribute to CAD development, even in individuals with normal lipid levels.
Purpose of the Study:
- To investigate the prevalence of serum lipid and apolipoprotein abnormalities in men with angiographically confirmed coronary artery disease.
- To identify key lipid and apolipoprotein markers that discriminate between patients with CAD and healthy controls.
- To assess the occurrence of these abnormalities in normolipidaemic patients with CAD.
Main Methods:
- Serum lipid profiles (cholesterol, triglyceride) and apolipoproteins A-I and B were measured.
- Participants included 174 men with CAD and 572 healthy controls.
- Statistical analyses, including discriminant function analysis, were used to compare groups and identify significant predictors.
Main Results:
- Two-thirds of CAD patients exhibited abnormal age-corrected lipid values (elevated cholesterol/triglyceride or low HDL cholesterol).
- 30% of normolipidaemic CAD patients had low apolipoprotein A-I levels.
- Elevated low-density lipoprotein (LDL)-apolipoprotein B was prevalent in normolipidaemic patients on beta-blockers.
- Raised serum triglyceride was the strongest discriminant, followed by elevated LDL-apolipoprotein B and reduced apolipoprotein A-I.
Conclusions:
- Hypertriglyceridaemia is a significant risk factor for coronary artery disease.
- Apolipoprotein abnormalities are frequent in CAD patients, including those with normal lipid profiles.
- These findings underscore the importance of assessing apolipoprotein levels in cardiovascular risk stratification.
Abstract:
Serum lipids and apolipoproteins A-I and B were measured in 174 men aged less than 60 with angiographically confirmed coronary artery disease and in 572 healthy control men. Two thirds of the patients had raised age-corrected values of fasting serum cholesterol and/or triglyceride and/or a low high density lipoprotein (HDL) cholesterol compared with the controls. Eighteen (30%) of the 61 normolipidaemic patients had a concentration of serum apolipoprotein A-I below the 5th percentile of 233 controls. In normolipidaemic patients on beta blockers the relative prevalence of serum low density lipoprotein (LDL)-apolipoprotein B values above the 95th percentile of 339 controls was significantly increased. Discriminant function analysis showed that a raised concentration of serum triglyceride was the best discriminant between patients and controls, with raised LDL-apolipoprotein B and reduced apolipoprotein A-I coming second only to triglyceride in analyses where each was separately compared with all the lipid variables. These associations were highly significant and were independent of other influences, including beta blockade. These findings re-emphasise the importance of hypertriglyceridaemia as a risk factor and confirm that apolipoprotein abnormalities occur frequently in coronary disease, even in normolipidaemic patients.