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The role of lipoprotein A-I and lipoprotein A-I/A-II in predicting coronary artery disease

T O'Brien1, T T Nguyen, B J Hallaway

  • 1Atherosclerosis Research Unit, Mayo Clinic and Foundation, Rochester, Minn., USA.

Arteriosclerosis, Thrombosis, and Vascular Biology
|February 1, 1995
PubMed

Insights

High-density lipoprotein (HDL) subparticles, LpA-I and LpA-I/A-II, are lower in patients with coronary artery disease. However, plasma apolipoprotein A-I alone best predicts coronary artery disease presence.

Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Biochemistry

Background:

  • High-density lipoprotein (HDL) plays a crucial role in reverse cholesterol transport.
  • Specific HDL subparticles, including those containing apolipoprotein (apo) A-I alone (LpA-I) and with apoA-I and apoA-II (LpA-I/A-II), may have differential roles in cardiovascular disease risk.
  • Understanding the predictive value of these subparticles is important for assessing coronary artery disease (CAD) risk.

Purpose of the Study:

  • To investigate the association between LpA-I and LpA-I/A-II levels and the presence of significant coronary artery disease.
  • To compare the predictive capabilities of LpA-I, LpA-I/A-II, and plasma apoA-I in individuals with and without confirmed CAD.

Main Methods:

  • A case-control study comparing 184 patients with angiographically confirmed CAD and 191 healthy controls.
  • Measurement of LpA-I and LpA-I/A-II using magnetic beads with anti-apoA-II antibodies for particle separation.
  • Analysis of plasma total cholesterol, triglyceride, HDL cholesterol, and apoA-I levels.

Main Results:

  • Subjects with CAD exhibited lower levels of HDL cholesterol, plasma apoA-I, LpA-I, and LpA-I/A-II compared to controls.
  • Plasma apoA-I emerged as the strongest independent predictor of coronary artery disease.
  • Despite being lower in CAD patients, LpA-I and LpA-I/A-II did not significantly improve CAD prediction beyond plasma apoA-I.

Conclusions:

  • LpA-I and LpA-I/A-II concentrations are reduced in individuals with coronary artery disease.
  • Plasma apoA-I is a more potent predictor of coronary artery disease than LpA-I or LpA-I/A-II.
  • The addition of LpA-I and LpA-I/A-II measurements does not enhance the prediction of coronary artery disease when plasma apoA-I is considered.

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