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Relation of angiographically defined coronary artery disease to plasma lipoprotein subfractions and apolipoproteins
Insights
Men with severe coronary artery disease had significantly lower HDL2 cholesterol levels. This finding highlights HDL2 cholesterol as a key indicator for coronary artery disease severity.
Area of Science:
- Cardiovascular Medicine
- Lipidology
- Biochemistry
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Plasma lipoproteins play a crucial role in the development of atherosclerosis.
- Understanding the relationship between specific lipoprotein subfractions and CAD severity is essential for risk stratification.
Purpose of the Study:
- To investigate the association between plasma lipoprotein subfractions and the severity of coronary artery disease.
- To identify specific lipid markers that correlate with the extent of coronary stenoses.
Main Methods:
- Coronary angiography was performed on 104 men aged 35-65 with suspected myocardial ischemia.
- A coronary score was assigned based on the number, degree, and length of stenoses in major coronary arteries.
- Lipid and apolipoprotein concentrations in various lipoprotein subfractions were measured using ultracentrifugation and electroimmunoassay.
Main Results:
- Men with higher coronary scores showed a trend towards lower high-density lipoprotein (HDL) cholesterol and higher low-density lipoprotein (LDL) cholesterol.
- A significant inverse correlation was observed between coronary score and HDL2 cholesterol concentration (p < 0.005), with severely affected patients having 44% lower HDL2 levels.
- No significant associations were found between coronary score and HDL3 cholesterol, very-low-density lipoprotein (VLDL) cholesterol, plasma triglycerides, or apolipoproteins AI, AII, and E.
Conclusions:
- Low HDL2 cholesterol concentration is strongly associated with the severity of coronary artery disease, specifically with an increased number of stenoses.
- HDL2 cholesterol may serve as a valuable biomarker for assessing CAD extent.
- Further research is warranted to explore the therapeutic implications of targeting HDL2 cholesterol in CAD management.
Abstract:
The relation of coronary artery disease to plasma lipoproteins was examined in 104 men aged 35-65 years undergoing coronary angiography for suspected myocardial ischaemia. A score reflecting the number, degree, and length of stenoses in seven major coronary arteries was assigned to each angiogram. Lipid concentrations in lipoprotein subfractions were measured after preparative ultracentrifugation; plasma apolipoprotein concentrations were measured by electroimmunoassay. Men with high coronary scores tended to have lower plasma high-density lipoprotein (HDL) cholesterol concentrations and higher low-density lipoprotein (density 1.019-1.063 g/ml) cholesterol concentrations than subjects of similar age with low coronary scores (p approximately equal to 0.1). The strongest relation, however, was with the cholesterol concentration in the HDL2 subfraction (density 1.063-1.125 g/ml) of HDL, which averaged 44% lower in the severely affected patients (p less than 0.005). No associations were found between the coronary score and HDL3 cholesterol, the cholesterol content of lipoproteins of density less than 1.019 g/ml, plasma triglyceride, or the concentrations of apolipoproteins AI, AII, and E. The high coronary scores associated with low HDL2 concentrations reflected an increase in the number of both partial and complete stenoses distributed throughout the coronary tree. In contrast the sizes of the lesions and the proportion producing complete occlusion were unrelated to HDL2.