Abstract
Several parameters and risk factors were compared between Korean male myocardial infarction (MI) patients (n=10) and angina pectoris (AP) patients (n=17) to search unique biomarkers for myocardial infarction (MI) in lipoprotein level. Individual serum and lipoprotein fractions (VLDL, LDL, HDL2, HDL3) were isolated and analyzed by lipid and protein determination and enzyme assay. The MI group was found to have a 25 and 30% higher serum cholesterol and triacylglycerol (TG) level than the AP group, respectively, however, their body mass index (BMI), LDL-cholesterol (C), HDL-C, and glucose levels fell within the normal range. MI patients were found to have an approximately two-fold higher level of serum IL-6 and an 18% lower serum apoA-I level than that of the AP group. LDL and HDL2 fraction of the MI group were more enriched with TG than those of AP group. The increased TG was correlated well with the increased level of apoC-III in the same fraction. Cholesteryl ester transfer protein (CETP) activity and protein level were greatly increased in MI patients in the LDL and HDL3 fractions. MI patients showed more severely oxidized LDL fraction than patients in the AP group, as well as the weakest antioxidant ability of serum. Conclusively, MI patients were found to have unique serum and lipoprotein characteristics including increased IL-6 and TG in serum, with CETP and apoC-III in the LDL and HDL fractions, as well as severely impaired antioxidant ability of HDL.
Highlights
Coronary heart disease (CHD) is responsible for the vast majority of cases of unstable angina, acute myocardial infarction (MI), and sudden death
The serum apoA-I level was significantly decreased by up to 18% in the MI group when compared with angina pectoris (AP) group, indicating that decreased apoA-I can be a specific marker for acute coronary syndrome (ACS), especially in cases of MI
The MI patients showed typical diagnostic characters of the Asian-Pacific population, including not being obese and having normal level of total cholesterol (TC) and HDL-C. Those numbers are fall in normal ranges suggested by the national cholesterol education program-adult treatment panel (NCEP-ATP) III guidelines. This indicates that simple application of the NCEP guideline might be limited in its ability to identify the risk of MI for Asian-Pacific patients
Summary
Coronary heart disease (CHD) is responsible for the vast majority of cases of unstable angina, acute myocardial infarction (MI), and sudden death. Several biomarkers have been reported to predict cardiovascular risk, there have been no useful biomarkers developed for the early detection of MI (Pahor et al, 1999). Inflammation is a major risk factor of atherosclerosis, and several inflammatory biomarkers such as high sensitivity C-reactive protein (hsCRP), cytokines, biomarkers of endothelial cell activation, and proinflammatory enzymes have been established for the diagnosis of ACS (Hartford et al, 2007); no studies have been reported to determine if these biomarkers are useful for the prediction of acute MI
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