Abstract

Atherosclerosis is the most important contributor to increasing burden of coronary artery disease (CAD). Growing evidence suggests that the ratios of Apo B/Apo A-I and Lp(a) are better indexes for risk assessment of CAD. Elevated plasma levels of lipoprotein(a) in humans represent a major in-herited risk factor for atherosclerosis. Thus, a study was performed to determine the association betwwen serum Apo B, Apo A-I, and lipoprotein(a) levels, and severity of CAD in patients with CAD confirmed on coronary angiography findings. An analytical case control study was carried out with 85 patients (58 males and 27 females) 40 - 60 years of age confirmed as having CAD on coronary angiography and 85 age and sex matched healthy volunteers as controls. Serum samples were an-alyzed for Apo A-1 LDL, Apo B, Apo A-I, and lipoprotein(a) concentration and the severity of CAD was assessed using coronary angiography scoring method. Patients with CAD had significantly high serum LDL-C, Apo B and Lp(a) levels compared to control subjects. However, serum Apo A-I level did not show a significant difference between two groups. Subjects with a positive family history of CAD with increased serum Lp(a) ≥ 17.3 mg/dL have high risk for development of CAD. Present study suggests that serum Lp(a) cut-off value of 17.3 mg/dL may be an important predictor in ruling out major vessel disease and luminal narrowing by atheroma.

Highlights

  • Atherosclerosis is the most important contributor to increasing burden of coronary artery disease (CAD)

  • The precise mechanisms involved in the pathogenesis are not clear, it has been postulated that the reactive oxygen species (ROS) formation in vascular endothelial cells can promote conversion of low density lipoprotein cholesterol (LDL-C) to atherogenic oxidized LDL

  • An analytical case control study was carried out with 85 patients (58 males and 27 females) 40 - 60 years of age confirmed as having CAD on coronary angiography findings at Cardiology Unit, National Hospital and Nawaloka Hospitals PLC, Colombo Sri Lanka during 2013 and 2014

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Summary

Introduction

Atherosclerosis is the most important contributor to increasing burden of coronary artery disease (CAD). The precise mechanisms involved in the pathogenesis are not clear, it has been postulated that the reactive oxygen species (ROS) formation in vascular endothelial cells can promote conversion of low density lipoprotein cholesterol (LDL-C) to atherogenic oxidized LDL (oxLDL). This oxLDL and the subsequent generation of lipidperoxidase accelerate the development of atherosclerotic plaque [1] [2].

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