Apolipoproten B, LDL Cholesterol and apoB/apoA-I Ratio in Patients With Stable Angina
Abstract
Aim: To acknowledge the nature of correlation between apolipoprotein B concentrations and LDL cholesterol levels in patients with stable angina pectoris and also to show that the ratio of apoB/apoA-I may be a promising predictor for the risk of cardiovascular disease.Methods: This is an observational study with cross-sectional approach of 34 patients with stable angina pectoris. Prior to the study, patients were advised to fast for 10-12 hours and must complete the informed consent. Patients underwent physical examination and anthropometric measurements (height, body weight, waist circumference), blood test, and ECG check.
Results: From 34 patients, the prevalence of high levels of total cholesterol (>200 mg/dl) in men and women are 45.5% and 47.8%, respectively; and 90.9% men and 87% women with increased LDL-C (?100 mg/dl). Low value of apoA-I was determined in 5 men (45.5%) and 4 women (17.4%); and high value of apoB was found in 7 men (63.6%) and 11 women (47.8%), whereas 13 subjects with unfavorable apoB/apoA-I ratio. Six subjects had low levels of apoA-I along with high levels of apoB. ApoB/apoA-I ratio above 0.9 was found in 6 or 11 men (54.5%) and 7 of 23 women (30.4%).
Conclusion: We found that in 34 patients with stable angina, 18 of them (52.9%) showed high plasma apoB concentration. This is parallel to 30 subjects (88.2%) with high LDL cholesterol levels, and also 13 subjects (38.2%) with high apoB/apoA-I ratio. It can be concluded the higher the ratio of apoB to apoA-I, the greater the risk of cardiovascular disease. Lifestyle management and pharmacological intervention in dyslipidemia is important in reduction of cardiovascular events.
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References
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2. Chan DC, Barrett PHR, Watts GF. The metabolic and pharmacologic bases for treating atherogenic dyslipidemia. Best Pract Res Clin Endocrinol Metab 2014; 28:369-385.
3. Ramjee V, Sperling LS, Jacobson TA. Non-high-density lipoprotein cholesterol versus apolipoprotein B in cardiovascular risk stratification. J Am Coll Cardiol 2011; 58:457-463.
4. Orringer CE. Non-HDL cholesterol, apoB and LDL particle concentration in coronary heart disease risk prediction and treatment. Clin Lipidol 2013; 8:69-79.
5. Contois JH, McConnell, Sethi AA, Csako G, Devaraj S, Hoefner DM, Warnick GR. Apolipoprotein B and cardiovascular disease risk: Position statement from the AACC lipoproteins and vascular diseases division working group on best practices. Clin Chem 2009; 55:407-419.
6. Walldius G. The apoB/apoA-I ratio is a strong predictor of cardiovascular risk. In: Frank S, Kostner G. eds. Lipoproteins – Role in health and diseases. 2012. http://dx.doi.org/10.5772/47869
7. Walldius G, Jungner I. Rationale for using apolipoprotien B and apolipoprotein A-I as indicators of cardiac risk and as targets for lipid-lowering therapy. Eur Heart J 2005; 26:210-212.
8. Barter PJ, Ballantyne CM, Carmena R, Cabezas MC, Chapman JC, Couture P, De Graaf J, Durrington PN, Faergeman O, Frohlich J, Furberg CD, Gagne C, Haffner SM, Humphries SE, Jungner I, Krauss RM, Kwiterovich P, Marcovina S, Packard CJ, Pearson TA, Reddy KS, Rosenson R, Saffarzadegan N, Sniderman AD, Stalenhoef AF, Stein E, Talmud PJ, Tonkin AM, Walldius G, Williams KMS. ApoB versus cholesterol in estimating cardiovascular risk and in guiding therapy: Report of the thirty-person/ten country panel. J Internal Med 2006; 259:247-258.
9. World Health Organization. Global atlas on cardiovascular disease prevention and control. WHO, 2001.
10. Tamang HK, Timilsina U, Singh KP, Shrestha S, Raman RK, Panta P, Karna P, Khadka L, Dahal C. ApoB/apoA-I ratio is statistically a better predictor of cardiovascular disease (CVD) than conventional lipid profile: A study from Kathmandu Valley, Nepal. J Clin Diagnostic Res 2014; 8:34-36.
11. The Task Force on the management of stable angina pectoris of the European Society of Cardiology. Guidelines on the management of stable angina pectoris: Executive summary. Eur Heart J 2006; 27:1341-1381.
12. Faulin TES, Cavalcante MF, Abdalla DSP. Role of electronegative LDL and its associated antibodies in the pathogenesis of atherosclerosis. Clin Lipidol 2010; 5:719-719.
13. Jian X, Yang Z, Chandrakala AN, Pressley D, Parthasarathy S. Oxidized low density lipoproteins- Do we know enough about them? Cardiovasc Drugs Ther 2011; 25:367-377.
14. Yang H, Mohamed AA, Zhou S. Oxidized low density lipoprotein, stem cells, and atherosclerosis. Lipids Health Dis 2012; 11:85-93.
15. Wu T, Willett WC, Rifai N, Shai I, Manson JE, Rimm EB. Is plasma oxidized low-density lipoprotein, measured with the widely used antibody 4E6, an independent predictor of coronary heart disease among US men and women? J Am Coll Cardiol 2006; 48:973-979.
16. Kovanen PT, Jauhiainen M. Coronary heart disease prediction: Apolipoprotein B shows its might again – but still in vain? Eur J Preventive Cardiol 2015; 0:1-4.
17. Kaneva AM, Potolitsyna NN, Bojko ER, Odland JO. The apolipoprotein B/apolipoprotein A-I ratio as a potential marker of plasma atherogenicity. Disease Markers 2015: 1-7.
18. Lu M, Lu Q, Zhang Y, Tian G. ApoB/apoA-I is an effective predictor of coronary heart disease risk in overweight and obesity. J Biomed Res 2011; 25:266-273.
19. Ding D, Li X, Qiu J, Li R, Zhang Y, Su D, Li Z, Wang M, Lv X, Wang D, Yang Y, Xia M, Li D, Hu G, Ling W. Serum lipids, apolipoproteins and mortality among coronary artery disease patients. Biomed Res Int 2014: 1-11.
20. Robinson JG, Wang S, Jacobson TA. Meta-analysis of comparison of effectiveness of lowering apolipoprotein B versus low-density lipoprotein cholesterol and nonhigh-density lipoprotein cholesterol for cardiovascular risk reduction in randomized trials. Am J Cardiol 2012; 110:1468-1476.
21. Jing F, Mao Y, Guo J, Zhang Z, Li Y, Ye Z, DingY, Wang J, Jin M, Chen K. The value of apolipoprotein B/apolipoprotein A1 ratio for metabolic syndrome diagnosis in a Chinese population: A cross-sectional study. Lipids in Health Dis 2014; 13:81-87.
Published
2017-01-19
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How to Cite
Handayani, O., & Sargowo, D. (2017). Apolipoproten B, LDL Cholesterol and apoB/apoA-I Ratio in Patients With Stable Angina. Indonesian Journal of Cardiology, 37(1), 6-12. https://doi.org/10.30701/ijc.v37i1.550
Section
Clinical Research
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