Assessment of Levels of Apolipoproteins in Patients of Coronary Artery Diseases – A Cross Sectional Study

Abstract

Background and objectives Atherosclerotic disease implicates a multitude of risk factors, of which lipid and lipoprotein metabolism assumes central importance. Conventionally, serum lipid profile has been considered to be an important risk factor for development of coronary artery disease. The present study was undertaken to establish Apo AI, Apo B and ApoB/Apo AI as a new marker of atherosclerotic disease in patients with angiographically proven CAD with normal Lipid Profile. Methodology The present one year cross sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 100 patients with history suggestive of Ischemic heart disease (clinically symptoms of ischemia like chest pain and ECG changes) including MI, Unstable angina and Stable angina were included.during the period of January 2010 to December 2010. Relevant investigations were done and Apo B to A ratio of more than 0.8 in females and 0.9 in males was considered as abnormal. Results Males outnumbered females (84% vs 16%) with male to female ratio of 5.25:1. Most of the patients (40%) were in the in the age group of 51 to 60 years Dyslipidemia was found to be the most common risk factor (46%). A large proportion of the patients were in the obese I group (72%). Majority of the patients (88%) had abnormal apo B to A ratio. Significant obstructive CAD was IX noted in 87% patients of which 46% had single vessel disease, 23% double vessel disease and 18% had triple vessel disease. Of the 88 patients with abnormal Apo B/ Apo A ratio, 79 had coronary artery disease. Similarly, on the other hand out of 87 patients of CAD, 90.8% had abnormal ratio and 9.19% had normal ratio. This difference was statistically significant (p<0.001). Interpretation and conclusion Apolipoproteins (A and B) and their ratio may be better risk markers of coronary artery disease than conventional lipid profile.