Small dense LDL particles - a predictor of coronary artery disease evaluated by invasive and CT-based techniques: a case-control study

Anne P Toft-Petersen,Annette Andreasen,Erik B Schmidt,Inge V Aardestrup,Klaus Rasmussen,Hans H Tilsted,Thorkil Christensen,Bruce A Griffin,Jens Aarøe

doi:10.1186/1476-511x-10-21

Abstract

BackgroundCoronary angiography is the current standard method to evaluate coronary atherosclerosis in patients with suspected angina pectoris, but non-invasive CT scanning of the coronaries are increasingly used for the same purpose.Low-density lipoprotein (LDL) cholesterol and other lipid and lipoprotein variables are major risk factors for coronary artery disease. Small dense LDL particles may be of particular importance, but clinical studies evaluating their predictive value for coronary atherosclerosis are few.MethodsWe performed a study of 194 consecutive patients with chest pain, a priori considered of low to intermediate risk for significant coronary stenosis (>50% lumen obstruction) who were referred for elective coronary angiography. Plasma lipids and lipoproteins were measured including the subtype pattern of LDL particles, and all patients were examined by coronary CT scanning before coronary angiography.ResultsThe proportion of small dense LDL was a strong univariate predictor of significant coronary artery stenosis evaluated by both methods. After adjustment for age, gender, smoking, and waist circumference only results obtained by traditional coronary angiography remained statistically significant.ConclusionSmall dense LDL particles may add to risk stratification of patients with suspected angina pectoris.

Highlights

Coronary artery disease (CAD) is a common cause of morbidity and mortality in the industrialised world [1]
Invasive coronary angiography (CAG) When stratified by invasive CAG (Table 2), patients with CAD were significantly more likely to be of male gender and to receive lipid-lowering drugs
Unadjusted Small dense LDL particles (sdLDL) was a significant predictor of presence of CAD verified by invasive CAG in a logistic regression analysis (Table 3; Crude)

Summary

Introduction

Coronary artery disease (CAD) is a common cause of morbidity and mortality in the industrialised world [1]. The diagnosis of coronary atherosclerosis is usually made by invasive coronary angiography (CAG) during which percutaneous coronary intervention (PCI) procedures can be applied simultaneously. Among the currently available non-invasive alternatives, CT-based coronary angiography (CT CAG) provides a view of the vessel lumen as well as the architecture of the vessel wall. An elevated concentration of LDL cholesterol is a major risk factor for CAD [4,5,6]. Coronary angiography is the current standard method to evaluate coronary atherosclerosis in patients with suspected angina pectoris, but non-invasive CT scanning of the coronaries are increasingly used for the same purpose. Low-density lipoprotein (LDL) cholesterol and other lipid and lipoprotein variables are major risk factors for coronary artery disease. Small dense LDL particles may be of particular importance, but clinical studies evaluating their predictive value for coronary atherosclerosis are few

Methods

Results

Discussion

Conclusion