Abstract
Aim: To acknowledge the nature of correlation between apolipoprotein B concentrations and LDL cholesterol levels in patients with stable angina pectoris and also to show that the ratio of apoB/apoA-I may be a promising predictor for the risk of cardiovascular disease.Methods: This is an observational study with cross-sectional approach of 34 patients with stable angina pectoris. Prior to the study, patients were advised to fast for 10-12 hours and must complete the informed consent. Patients underwent physical examination and anthropometric measurements (height, body weight, waist circumference), blood test, and ECG check.Results: From 34 patients, the prevalence of high levels of total cholesterol (>200 mg/dl) in men and women are 45.5% and 47.8%, respectively; and 90.9% men and 87% women with increased LDL-C (?100 mg/dl). Low value of apoA-I was determined in 5 men (45.5%) and 4 women (17.4%); and high value of apoB was found in 7 men (63.6%) and 11 women (47.8%), whereas 13 subjects with unfavorable apoB/apoA-I ratio. Six subjects had low levels of apoA-I along with high levels of apoB. ApoB/apoA-I ratio above 0.9 was found in 6 or 11 men (54.5%) and 7 of 23 women (30.4%).Conclusion: We found that in 34 patients with stable angina, 18 of them (52.9%) showed high plasma apoB concentration. This is parallel to 30 subjects (88.2%) with high LDL cholesterol levels, and also 13 subjects (38.2%) with high apoB/apoA-I ratio. It can be concluded the higher the ratio of apoB to apoA-I, the greater the risk of cardiovascular disease. Lifestyle management and pharmacological intervention in dyslipidemia is important in reduction of cardiovascular events.
Highlights
Atherogenic dyslipidemia (AD) is characterized by high plasma triglycerides, low high-density lipoprotein-cholesterol (HDL-C) and a high concentration of apolipoproteinB-containing lipoproteins, elevated small, dense low-density lipoprotein (LDL) particles
The present study has shown the close association of apolipoprotein with the development of atherosclerosis, and the apolipoprotein B (apoB)/apoA-I ratio becomes strong predictor of cardiovascular events, stable angina pectoris in particular, than other lipid parameters such as total cholesterol, LDL and HDL cholesterols
We propose that calculation of the LDL/HDL ratio may underestimate the risk in some patients compared with the use of apoB/apoA-I ratio, yet more studies are necessary to confirm its benefits as predictor of Cardiovascular disease (CVD)
Summary
Atherogenic dyslipidemia (AD) is characterized by high plasma triglycerides, low high-density lipoprotein-cholesterol (HDL-C) and a high concentration of apolipoprotein (apo). B-containing lipoproteins, elevated small, dense LDL particles. Effective diagnosis and management of atherogenic dyslipidemia requires an overall assessment for CVD risk, including age, presence of established CVD, hypertension or diabetes mellitus, family history of CVD and smoking.[2] Emerging research has identified potential surrogate lipid markers for assessing cardiovascular risk, including apolipoprotein B (apoB), small dense LDL, LDL particle number, and nonhigh-density lipoprotein cholesterol (non-HDL-C).[3]. A reduction in the concentration of non-HDL-C has been found to be a consistent marker of lower coronary heart disease risk on therapy. A meta-analysis of 14 statin trials, seven fibrate trials and seven trials of niacin monotherapy or combination therapy, showed a relationship between the percentage of nonHDL-C lowering and CVD risk reduction. Non-HDL-C was found to be a strong predictor of all-cause mortality and CVD mortality than LDL-C.4 The concentration of non-HDL-C has been demonstrated to be highly correlated with that of apoB
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