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Correlation of lipoprotein (a) to angiographically defined coronary artery disease in Indians
1Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
Insights
Lipoprotein (a) [Lp(a)] is a better predictor of coronary artery disease (CAD) in Indian patients than traditional lipid markers. Higher Lp(a) levels significantly correlate with the presence and severity of angiographically defined CAD.
Area of Science:
- Cardiology
- Clinical Biochemistry
- Preventive Medicine
Background:
- Lipoprotein (a) [Lp(a)] levels are known to correlate with coronary artery disease (CAD).
- Lp(a) distribution patterns vary across different racial groups.
- Understanding Lp(a) in diverse populations like Indians is crucial for CAD risk assessment.
Purpose of the Study:
- To investigate the relationship between Lp(a) levels and angiographically defined CAD in Indian patients.
- To compare the predictive value of Lp(a) against traditional lipid profiles for CAD.
- To assess the graded association between Lp(a) concentration and CAD severity.
Main Methods:
- Plasma Lp(a) and lipid profiles were measured in 101 Indian patients undergoing coronary arteriography.
- Patients were categorized into CAD and normal coronary artery groups.
- Lp(a) and lipid levels were analyzed across different quartiles and compared between groups.
Main Results:
- Lp(a) concentrations were significantly higher in patients with CAD compared to those without (26.83 vs. 15.07 mg/dl, P < 0.05).
- A graded association was observed, with CAD prevalence increasing across Lp(a) quartiles, reaching 100% in the highest quartile (> or = 76 mg/dl).
- Traditional lipid markers including total cholesterol, triglycerides, HDL, LDL, and their ratios did not show significant differences between CAD and normal groups, except for HDL which was not significantly different.
Conclusions:
- Lp(a) measurement is a superior marker for predicting angiographically defined CAD in Indian patients compared to traditional lipid measures.
- Elevated Lp(a) levels demonstrate a strong, graded association with the presence and severity of coronary artery disease.
- Further research into Lp(a) 's role in cardiovascular risk stratification in diverse ethnic groups is warranted.
Abstract:
Lipoprotein (a) [Lp(a)] levels have been correlated with angiographically defined coronary artery disease (CAD). Pattern of Lp(a) distribution in various racial groups is different. To study this relationship in Indian patients, plasma levels of Lp(a) and other lipid values were assessed in 101 patients undergoing coronary arteriography. Lp(a) concentration was higher in CAD group (n = 77) compared to normal coronary artery group (n = 24) (26.83 +/- 22.09 mg/dl vs. 15.07 +/- 14.61 mg/dl, P < 0.05). Lp(a) values had graded association with CAD. In Lp(a) quartile of < 5 mg/dl, 66.7% patients had CAD; in Lp(a) quartile of 5-25 mg/dl, 69.0% had CAD; Lp(a) quartile of 26-75 mg/dl, 87.5% had CAD; and in Lp(a) quartile of > or = 76 mg/dl, all patients had CAD. High density lipoprotein (HDL) cholesterol was higher in the normal coronary artery group as compared to CAD group (45.25 +/- 8.26 mg/dl vs. 41.83 +/- 16.47 mg/dl; NS). In HDL quartile of < 35 mg/l, 88.9% patients had angiographically defined CAD. Plasma values of total cholesterol, triglycerides (TG), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), low density lipoprotein (LDL) cholesterol, LDL/HDL cholesterol ratio and Apo A1/B ratio were not significantly different in the groups with normal coronary arteries and CAD. Our results indicate that the measurement of Lp(a) provides a better marker for predicting the presence of angiographically defined CAD as compared to traditional measures.