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Lipid abnormalities in Greek patients with coronary artery disease
M S Elisaf1, K C Siamopoulos, T J Tselegarides
1Department of Internal Medicine, University of Ioannina, Greece.
Insights
Lipid abnormalities are common in Greek patients with premature coronary artery disease (CAD). Most patients showed abnormal lipid profiles, highlighting the need for comprehensive lipid testing in CAD risk assessment.
Area of Science:
- Cardiology
- Lipidology
- Preventive Medicine
Background:
- Dyslipidemia is a significant risk factor for premature coronary artery disease (CAD).
- Characterizing lipid disorders in diverse ethnic groups with premature CAD is crucial for effective risk management.
- Previous studies have not fully elucidated the specific lipid abnormalities in Greek populations with premature CAD.
Purpose of the Study:
- To investigate the types and prevalence of lipid disorders in patients with premature CAD in Northwestern Greece.
- To compare lipid profiles and dyslipidemic phenotypes between premature CAD patients and asymptomatic controls.
Main Methods:
- A case-control study involving 108 premature CAD patients and 104 asymptomatic controls from Northwestern Greece.
- Diagnostic arteriography was used to confirm CAD (lumen narrowing ≥70%).
- Serum levels of total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, Apo B, Apo A1, and Lp(a) were measured.
Main Results:
- Premature CAD patients exhibited significantly higher levels of total cholesterol, LDL cholesterol, triglycerides, Apo B, and Lp(a), and lower levels of HDL cholesterol and Apo A1 compared to controls.
- Lipoprotein or apolipoprotein abnormalities were present in 82.4% of CAD patients.
- The most common dyslipidemic phenotypes in CAD patients were type IIA, hypoalpha, and hyperApoB, with a higher incidence compared to controls.
Conclusions:
- The majority of Greek patients with premature CAD present with significant lipid and lipoprotein abnormalities.
- Traditional lipid parameters are often sufficient for defining these abnormalities, but apolipoproteins and Lp(a) may provide additional diagnostic value in select cases.
- These findings underscore the importance of thorough lipid assessment in the management of premature CAD in this population.
Abstract:
Lipid abnormalities are major risk factors for premature coronary artery disease (CAD). However, the type and prevalence of dyslipidemia in these patients have not been well characterised, especially in some ethnic groups. The purpose of the present work was to determine the lipid disorders in patients of Northwestern Greece with premature CAD. The study population comprised of 132 men and 38 women who underwent elective diagnostic arteriography in our University Hospital. Subjects with > or = 1 lesion that narrowed the lumen of any of the 15 coronary artery segments by > or = 70% were considered to be CAD cases (n=108), whereas those with narrowing < 70% were excluded (n=54). Asymptomatic subjects (n=104) matched for age and sex were taken as controls. Compared with the controls, patients with premature CAD had increased serum levels of total cholesterol, LDL cholesterol, triglycerides, Apo B, and Lp(a), and decreased serum levels of HDL cholesterol and Apo A1. A lipoprotein or apolipoprotein abnormality was identified in 89 CAD patients (82.4%). The increased serum Apo B level (> 130 mg/dl) was the most common lipid abnormality observed in 72 patients. However, the most prevalent dyslipidemic phenotypes in our patients were type IIA followed by hypoalpha and hyperApoB. Compared to the control population, CAD patients had increased incidence of IIA and hypoalpha phenotypes. On the contrary, a normal lipoprotein phenotype was more common in the control population compared to CAD patients (56.7% vs. 17.6%, P<0.001). We conclude that the majority of Greek patients with premature CAD exhibit lipid and lipoprotein abnormalities, which to a large extent can be defined by determining the traditional lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides). However, in some cases the value of the quantification of other lipid parameters such as apolipoproteins and Lp(a) should be taken into account.