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[Diagnostic value of lipids and apolipoproteins for assessment of atherogenic risk]
1Bezirkskrankenhauses Meiningen, Zentralklinik für Herz- Lungenkrankheiten, Bad Berka.
Insights
Apolipoprotein A-I, HDL3, and HDL cholesterol levels are key indicators for identifying coronary artery disease. The total/HDL cholesterol ratio effectively assesses disease severity in male patients.
Area of Science:
- Cardiovascular Medicine
- Clinical Chemistry
- Lipid Metabolism
Context:
- Coronary artery disease (CAD) is a significant health concern in male populations.
- Lipoprotein patterns play a crucial role in the development and progression of atherosclerosis.
- Accurate diagnostic markers are essential for early detection and risk stratification of CAD.
Purpose:
- To investigate the diagnostic significance of various lipoprotein parameters in differentiating male patients with coronary artery disease from healthy individuals.
- To evaluate the efficacy of different lipoprotein markers in assessing the severity of coronary artery disease.
- To explore the influence of beta-receptor blocker medication on lipid profiles.
Summary:
- A study analyzed lipoprotein patterns in 242 male patients with varying degrees of coronary artery disease and 68 healthy controls.
- Apolipoprotein A-I (Apo A-I), HDL3 cholesterol, and HDL cholesterol demonstrated the highest diagnostic efficiency in distinguishing CAD patients (0.81, 0.76, 0.72 respectively).
- The total cholesterol to HDL cholesterol ratio proved most effective (0.67 efficiency) for assessing the severity of coronary vessel changes. Beta-receptor blocker use was associated with increased triglycerides and pre-beta-cholesterol.
Impact:
- Identifies specific lipoprotein markers (Apo A-I, HDL3, HDL cholesterol) with high diagnostic value for coronary artery disease.
- Provides a reliable ratio (total/HDL cholesterol) for quantifying CAD severity, aiding clinical decision-making.
- Highlights potential confounding effects of medications like beta-receptor blockers on lipid profiles, important for accurate interpretation.
Abstract:
In 242 coronarographed male patients (51.7 +/- 7.6 years) with 0-, 1-, 2- or 3-vessel diseases as well as a clinically healthy control group (n = 68, 50.6 +/- 8.5 years) the lipoprotein pattern was investigated: total-, LDL-, HDL-, HDL2-, HDL3-, beta-, pre-beta-alpha-cholesterol, triglycerides, apolipoproteins (Apo) A-I, A-II, B, (A-I)HDL, Lp(a). With regard to the separation of patients with diseases of the coronary vessels and healthy persons out of the individual parameters Apo A-I (turbidimetrically), HDL3 and HDL cholesterol had the greatest significance (maximal diagnostic efficiency: 0.81, 0.76, 0.72). For the assessment of the severity of the change of the coronary vessels the quotient total/HDL cholesterol was most suitable (efficiency: 0.67). Differences in the diagnostic significance were established in the determination of a parameter by means of different methods. The intake of beta-receptor blockers increased the concentration of the triglycerides and pre-beta-cholesterol.