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Apolipoprotein A-I as a marker of angiographically assessed coronary-artery disease
Insights
Plasma apolipoprotein A-I levels are superior to high-density-lipoprotein (HDL) cholesterol for identifying coronary-artery disease in men. This finding aids in better risk assessment for cardiovascular health.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Diagnostics
Background:
- Coronary-artery disease (CAD) is a leading cause of mortality.
- Identifying reliable biomarkers for CAD is crucial for early detection and prevention.
- High-density-lipoprotein (HDL) cholesterol is a known, but potentially limited, marker for CAD.
Purpose of the Study:
- To compare the discriminatory power of plasma apolipoprotein A-I versus HDL cholesterol in diagnosing angiographically confirmed CAD.
- To evaluate the independent and combined utility of these biomarkers in male subjects.
Main Methods:
- Cross-sectional study involving male patients with and without CAD.
- Measurement of plasma apolipoprotein A-I and HDL cholesterol levels.
- Statistical analysis using stepwise and linear discriminant analysis.
Main Results:
- Significantly lower plasma apolipoprotein A-I levels were observed in patients with CAD (96.7 mg/dL) compared to controls (146.9 mg/dL).
- Significantly lower HDL cholesterol levels were also found in patients with CAD (31.9 mg/dL) versus controls (45.9 mg/dL).
- Discriminant analysis revealed apolipoprotein A-I as a superior independent discriminator of CAD and showed it added significant value when combined with HDL cholesterol.
Conclusions:
- Plasma apolipoprotein A-I is a more effective biomarker than HDL cholesterol for identifying CAD in men.
- Apolipoprotein A-I measurement offers enhanced diagnostic value for CAD, potentially improving risk stratification.
Abstract:
This study was designed to determine whether the plasma level of apolipoprotein A-I is a better discriminator of angiographically documented coronary-artery disease than the level of high-density-lipoprotein (HDL) cholesterol in male subjects. The level of plasma apolipoprotein A-I in 83 patients with coronary-artery disease was 96.7 +/- 4.2 mg per deciliter (mean +/- S.E.M.), which was significantly lower (P less than 0.0001) than the level in 25 patients without coronary-artery disease (146.9 +/- 2.1 mg per deciliter). The levels of HDL cholesterol were also lower (P less than 0.0001) in patients with coronary-artery disease (31.9 +/- 1.5 mg per deciliter) than in those without it (45.9 +/- 2.3 mg per deciliter). A stepwise discriminant analysis, however, indicated the superiority of apolipoprotein A-I over HDL cholesterol in detecting coronary-artery disease. Furthermore, a linear discriminant analysis suggested that although HDL cholesterol by itself was a discriminator of coronary-artery disease, it did not provide a substantial increase in discriminatory value over that provided by apolipoprotein A-I; in contrast, apolipoprotein A-I levels added discriminatory value to the information obtained by measuring HDL cholesterol alone. We conclude that apolipoprotein A-I by itself is more useful than HDL cholesterol for identifying patients with coronary-artery disease.
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