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Cholesterol Subfraction Analysis in Patients with Acute Coronary Syndrome

[ Vol. 17 , Issue. 4 ]

Author(s):

Michal Kidawa, Anna Gluba-Brzozka*, Marzenna Zielinska, Beata Franczyk, Maciej Banach and Jacek Rysz   Pages 365 - 375 ( 11 )

Abstract:


Background: There is a close relationship between lipid metabolism disorders and atherosclerosis. Guidelines focus on lowering Low-Density Lipoprotein Cholesterol (LDL-C) levels. However, it should be kept in mind that LDL and High-Density Lipoprotein (HDL) consist of subfractions which can affect the progression of atherosclerosis.

Objective: We assessed the concentration of LDL and HDL subfractions in patients with Acute Coronary Syndromes (ACS). The influence of the presence of type 2 diabetes mellitus on LDL and HDL subfractions was also analyzed.

Methods: The study group consisted of 127 patients (62 men, 65 women) with ACS. All patients had coronary angiography and coronary angioplasty and stenting when necessary. Medical history was collected during 12 months of follow-up. HDL and LDL subfraction distribution was measured using Lipoprint (Quantimetrix).

Results: No differences in LDL nor HDL subfractions were observed between ST-Segment Elevation Myocardial Infarction (STEMI), Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) and unstable angina (UA) patients. However, those with restenosis and the necessity of repeated revascularization had higher levels of intermediate-density lipoprotein C (IDL-C) (p=0.055) and LDL3 (p=0.048) as compared with the patients without, while the level of IDL A (IDLA) was lower than in the latter group (p=0.036). In diabetic patients, the percentage share of HDL10 and small-dense HDL was significantly higher while the share of HDL1 (small-dense) (p=0.028), HDL4 (intermediate density) (p=0.052) and HDL5 (intermediate density) (p=0.060) were lower than in patients without DM.

Conclusion: Patients with multi-vessel CAD disease had higher levels of LDL3 subfraction and IDL-C and a lower proportion of IDLA.

Keywords:

Acute coronary syndrome, HDL subfractions, LDL subfractions, diabetes mellitus, restenosis, atherosclerosis.

Affiliation:

Department of Intensive Cardiac Therapy, Central Teaching Hospital of the Medical University of Lodz, Lodz, Department of Nephrology, Hypertension and Family Medicine, WAM Teaching Hospital, Zeromskiego 113; 90-549 Lodz, Department of Intensive Cardiac Therapy, Central Teaching Hospital of the Medical University of Lodz, Lodz, Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz, Department of Hypertension, Medical University of Lodz, Lodz, Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz



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