Small dense LDL particles strong predictor of CAD
MedWire News: Small dense low-density lipoprotein (sdLDL) particles are strong predictors of coronary atherosclerosis in patients with suspected angina pectoris, research shows.
"The proportion of sdLDL particles is a strong univariate predictor of clinically significant coronary luminal stenosis and, in this data set, as strong a predictor as high-density lipoprotein (HDL) cholesterol," say Erik Berg Schmidt (Aarhus University Hospital, Aalborg, Denmark) and team.
They add that this further supports the value of not only measuring LDL and HDL cholesterol in risk assessment for coronary artery disease (CAD), but also the distribution and quality of small dense particles within each subfraction.
The researchers measured plasma lipid and lipoprotein levels, including the subtype pattern of LDL particles, in 194 patients with chest pain who were considered at low-to-intermediate risk for significant coronary stenosis (>50% lumen obstruction).
All patients were examined by non invasive CT-based coronary angiography (CT CAG), as well as invasive CAG - the current standard method for evaluating coronary atherosclerosis in patients with suspected angina pectoris.
The researchers found that patients with CAD had a significantly higher proportion of sdLDL particles than patients without CAD, at an average 45.8% versus 39.5%, respectively, when verified by CT CAG, and 50.1% versus 40.0%, when verified by CAG.
Reporting in the journal Lipids in Health and Disease, the researchers say that unadjusted sdLDL measurements were significant predictors of CAD when assessed by CT CAG and CAG. However, after adjusting for age, gender, smoking, and waist circumference, only results obtained by traditional CAG remained statistically significant.
"This could in part be explained by a reduced sample size, but it might also reflect the fact that more participants in our study were classified as having CAD on CT examination than on invasive CAG," say Schmidt and co-authors.
They conclude that their study demonstrates the clinical utility of CAG which, in contrast to expensive nuclear magnetic resonance analysis, could be routinely incorporated into clinical risk assessment.
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By Nikki Withers