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[Blood plasma lipids and apolipoproteins as indicators of coronary atherosclerosis]
Insights
The apolipoprotein B/apolipoprotein AI ratio effectively differentiates coronary heart disease (CHD) from neurocirculatory dystonia (NCD). Combining this ratio with age and blood pressure significantly improves diagnostic accuracy for CHD.
Area of Science:
- Cardiology
- Biochemistry
- Medical Diagnostics
Background:
- Coronary heart disease (CHD) diagnosis can be challenging, especially differentiating it from conditions like neurocirculatory dystonia (NCD).
- Plasma lipid and apolipoprotein profiles are crucial biomarkers in cardiovascular health assessment.
Purpose of the Study:
- To evaluate the diagnostic value of single and combined plasma lipid and apolipoprotein parameters.
- To differentiate between CHD with coronary atherosclerosis and NCD using biochemical markers.
Main Methods:
- Stepwise discriminant analysis was employed to assess diagnostic capabilities.
- Key parameters analyzed included plasma lipids, apolipoproteins (apo B/apo AI ratio), age, and systolic blood pressure.
Main Results:
- The apolipoprotein B/apolipoprotein AI (apo B/apo AI) ratio demonstrated the highest single-marker accuracy (74%) in distinguishing CHD from NCD.
- This ratio's discriminating power was comparable to the cholesterol atherogenic index.
- A combination of apo B/apo AI ratio, age, and systolic blood pressure achieved the best diagnostic performance, reducing error to 18%.
Conclusions:
- The apo B/apo AI ratio is a valuable single biomarker for differentiating CHD and NCD.
- Combined analysis of apo B/apo AI ratio, age, and systolic blood pressure offers a highly accurate diagnostic approach for CHD.
Abstract:
An assessment of one-feature and combined diagnostic value of plasma lipid and apolipoprotein parameters, using stepwise discriminant analysis, was designed to make possible correct differentiation between coronary heart disease (CHD) due to angiographically-verified coronary atherosclerosis and neurocirculatory dystonia (NCD) without signs of coronary arterial affection. The apolipoprotein B/apolipoprotein AI (apo B/apo AI) ratio was shown to be the best single apolipoprotein marker capable of correct differentiation between CHD and NCD in 74% of cases. It was similar to the best lipid diagnostic marker, the cholesterol atherogenic index, in terms of discriminating power. The combination of the apo B/apo AI ratio + age + systolic arterial blood pressure proved to be the best combined indicator, bringing the diagnostic error down to 18%.