Lipoprotein(a), total/HDL-cholesterol ratio, ApoB/ApoA ratio as risk factors for atherogenesis in patients with coronary artery disease

Danica Labudovic1,*, Sonja Alabakovska1, Katerina Tosheska Trajkovska1, Jasna Bogdanska1, Silvana Jovanova2

1Department of Medical and Experimental Biochemistry, 2University Cliniv of Cardiology, Ss. Cyril and Methodius University in Skopje, School of Medicine, Skopje, The Former Yugoslav Republic Of Macedonia

Introduction: Serum high lipoprotein(a) levels are associated with increased risk of  development of atherogenesis in CAD patients

Objectives: The aim of this study was to determine the relative risks of association of high Lp(a) levels and both atherogenetic ratios: total/HDL cholesterol ratio and ApoB/ApoA ratio  for development of atherosclerosis in CAD patients compared to control subjects.

Methods: The plasma levels of Lp(a), ApoB and ApoA were determined using imunonephelometric kits and lipid parameters (total, HDL-, LDL-cholesterol) using enzymatic standard kits. Atherogenic ratios were calculated mathematically.

Results: The Lp(a) levels were statistically significantly increased in all CAD patients, compared to  control subjects (p< 0.008). The  calculated relative risk showed that CAD patients with plasma Lp(a) levels over 30 mg/dl and total cholesterol (5.17-6,29mmol/L) had the highest statistically  significant risk for development atherosclerosis (RR-9.18;95% CI:2.09-40.27; p<0.0003). But, almost 14–fold increase in risk was found in CAD patients with high Lp(a) levels (>30 mg/dl) and the highest total/HDL cholesterol ratio  (>5.8) (RR-13.76; 95%CI 3.25-58.24; p-1.8 x 10-6).The multiple regression analysis showed a high statistically significant association between plasma Lp(a) levels and the Apo B/ApoA ratio

Conclusion: Lp(a) levels in association with both atherogenetic ratios  total/HDL cholesterol ratio and Apo B/ApoA ratio may  play an important role as a risk factor for developing of atherosclerosis in CAD patients.

Keywords: Blood, Cardiovascular