High density lipoprotein heterogeneity & function among Indians with coronary artery disease

Area of Science:

• Cardiovascular Medicine
• Lipid Metabolism
• Biochemistry

Background:

• Impaired high density lipoprotein (HDL) functionality is a known risk factor for cardiovascular disease.
• HDL plays a crucial role in reverse cholesterol transport and possesses atheroprotective properties.

Purpose of the Study:

• To investigate alterations in HDL function, specifically antioxidative activity (AOA), and HDL subfraction distribution in patients with acute coronary syndrome (ACS) and stable coronary artery disease (SCAD).
• To assess the accuracy of HDL parameters in differentiating between ACS and SCAD individuals.

Main Methods:

• HDL subfraction distribution was analyzed using a precipitation method in 200 CAD patients (ACS and SCAD) and 60 controls.
• HDL antioxidative activity (AOA) was evaluated using a cell-free fluorescent assay, alongside paraoxonase (PON1) enzyme activity measurements.

Main Results:

• Higher HDL antioxidative activity (AOA) and paraoxonase (PON1) activity were associated with a lower likelihood of developing coronary artery disease (CAD).
• AOA correlated with the HDL2-C/HDL3-C ratio in controls and ACS patients.
• Combined analysis of AOA and HDL subfraction distribution achieved 72.8% accuracy in discriminating between ACS and SCAD groups.

Conclusions:

• Diminished HDL antioxidative activity (AOA) and altered HDL subfraction distribution may contribute to reduced anti-athero protective effects.
• These HDL alterations serve as discriminators between different patient groups with coronary artery disease.