Metabolic determinants of the course of coronary artery disease in men

1994 ◽  
Vol 40 (12) ◽  
pp. 2240-2246 ◽  
Author(s):  
G F Watts ◽  
S Mandalia ◽  
B M Slavin ◽  
J N Brunt ◽  
D J Coltart ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Plasma Concentrations ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Quantitative Coronary Angiography ◽  
Change In The Mean ◽  
Artery Disease

Abstract We examined associations between metabolic variables and changes in coronary artery disease (CAD) in the St. Thomas' Atherosclerosis Regression Study (STARS). The course of CAD over 3 years was measured continually by quantitative coronary angiography, i.e., as the per patient change in the mean absolute width of coronary segments (delta MAWS). The decrease in MAWS (progression of CAD) was significantly correlated with in-trial plasma concentrations of cholesterol (P = 0.002), low-density lipoprotein (LDL) cholesterol (P = 0.001), apolipoprotein B (apoB) (P = 0.008), and lipoprotein(a) [Lp(a)] (P = 0.004); no significant associations were found with high-density lipoprotein (HDL) cholesterol, apoA-I, vitamin E, thyroid hormones, fibrinogen, von Willebrand factor, or post-load plasma glucose and insulin concentrations. By multiple regression analysis, LDL cholesterol was the best predictor of delta MAWS, the adjusted model explaining 22% of the variance (P = 0.04). Thus, in men with symptomatic CAD the most important metabolic predictor of change in CAD is plasma LDL cholesterol, there being no advantage in measuring other variables, in particular, apoB or Lp(a).

Non-High-Density Lipoprotein Cholesterol in Patients With Metabolic Syndrome

2008 ◽  
Vol 56 (7) ◽  
pp. 931-936 ◽  
Author(s):  
Jian Huang ◽  
Roy Parish ◽  
Ishak Mansi ◽  
Herbert Yu ◽  
Estela M. Kennen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Metabolic Syndrome ◽  
Coronary Artery ◽  
High Density Lipoprotein ◽  
Therapeutic Target ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
High Density ◽  
Artery Disease

BackgroundMetabolic syndrome (MS) represents a cluster of cardiovascular risk factors that includes hypertriglyceridemia. Although low-density lipoprotein (LDL) cholesterol is the critical therapeutic target in patients with coronary artery disease, LDL cannot be calculated in those with excessive hypertriglyceridemia. Non-high-density lipoprotein (HDL) does not require LDL for calculation and may be an alternative therapeutic target in MS. The purpose of this study was to determine non-HDL cholesterol in relation to other lipid components and comorbidities in MS patients.MethodsA cross-sectional chart review on 928 public hospital patients was performed.ResultsMetabolic syndrome was present in 53% of all patients. Among those with MS, 87% had triglyceride level of greater than 150 mg/dL, 85% had low HDL, 71% had LDL of greater than 100 mg/dL, and 74% had non-HDL of greater than 130 mg/dL. The level of non-HDL cholesterol, but not total cholesterol or LDL cholesterol, was significantly higher (P < 0.05) and less at goal (P < 0.0001) in patients with MS. Diagnoses of coronary artery disease, hypertension, obesity, dyslipidemia, and diabetes were significantly more prevalent in MS patients (P < 0.0001).ConclusionCompared with those without MS, non-HDL level was significantly higher and undertargeted in patients with MS, in parallel with significantly higher prevalence of comorbidities.

Antibody titer against malondialdehyde-modified LDL compares with HDL cholesterol concentration in identifying angiographically verified coronary artery disease. Comparison of tests by ROC analysis

2005 ◽  
Vol 43 (4) ◽  
Author(s):  
Riikka Rontu ◽  
Saara Metso ◽  
Olli Jaakkola ◽  
Matti Nikkilä ◽  
Hannu Jokela ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antibody Titer ◽  
Roc Analysis ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cholesterol Concentration ◽  
Modified Ldl ◽  
Artery Disease

AbstractAntibody titer against malondialdehyde (MDA)-modified low-density lipoprotein (LDL) has been found to be associated with atherosclerosis, but it has not been established whether it would detect subjects with coronary artery disease (CAD). In the present study, receiver-operating characteristic (ROC) analysis was used to compare the diagnostic accuracy of the antibody titer against MDA-modified LDL and high-density lipoprotein (HDL) and LDL cholesterol levels in discrimination between subjects with (n=51) and without (n=35) angiographically verified 3-vessel CAD. As a result, the antibody titer against MDA-modified LDL was lower in subjects with CAD compared with subjects without CAD (p<0.0001). The area under the ROC plot was 0.822 (95% CI, 0.727 to 0.918) for the antibody titer and 0.769 (95% CI, 0.661 to 0.876) for the HDL cholesterol concentration. Both the antibody titer and the plasma HDL cholesterol level were more accurate markers of CAD than the LDL cholesterol level. As a conclusion, our results indicate that the antibody titer against MDA-modified LDL discriminates between subjects with widespread CAD and those without CAD similarly as the HDL cholesterol concentration. Moreover, the antibody titer against MDA-modified LDL is inversely correlated with the risk of severe CAD.

scholarly journals Baseline Low-Density-Lipoprotein Cholesterol Modifies the Risk of All-Cause Death Associated With Elevated Lipoprotein(a) in Coronary Artery Disease Patients

2022 ◽  
Vol 8 ◽  
Author(s):  
Younan Yao ◽  
Jin Liu ◽  
Bo Wang ◽  
Ziyou Zhou ◽  
Xiaozhao Lu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Penalized Spline ◽  
All Cause Mortality ◽  
Artery Disease

Background: The prognostic value of elevated lipoprotein(a) [Lp(a)] in coronary artery disease (CAD) patients is inconsistent in previous studies, and whether such value changes at different low-density-lipoprotein cholesterol (LDL-C) levels is unclear.Methods and Findings: CAD patients treated with statin therapy from January 2007 to December 2018 in the Guangdong Provincial People's Hospital (NCT04407936) were consecutively enrolled. Individuals were categorized according to the baseline LDL-C at cut-off of 70 and 100 mg/dL. The primary outcome was 5-year all-cause death. Multivariate Cox proportional models and penalized spline analyses were used to evaluate the association between Lp(a) and all-cause mortality. Among 30,908 patients, the mean age was 63.1 ± 10.7 years, and 76.7% were men. A total of 2,383 (7.7%) patients died at 5-year follow-up. Compared with Lp(a) &lt;50 mg/dL, Lp(a) ≥ 50 mg/dL predicted higher all-cause mortality (multivariable adjusted HR = 1.19, 95% CI 1.07–1.31) in the total cohort. However, when analyzed within each LDL-C category, there was no significant association between Lp(a) ≥ 50 mg/dL and higher all-cause mortality unless the baseline LDL-C was ≥ 100 mg/dL (HR = 1.19, 95% CI 1.04–1.36). The results from penalized spline analyses were robust.Conclusions: In statin-treated CAD patients, elevated Lp(a) was associated with increased risks of all-cause death, and such an association was modified by the baseline LDL-C levels. Patients with Lp(a) ≥ 50 mg/dL had higher long-term risks of all-cause death compared with those with Lp(a) &lt;50 mg/dL only when their baseline LDL-C was ≥ 100 mg/dL.

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