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. 2017 Jun;32(2):186-192.
doi: 10.1007/s12291-016-0592-7. Epub 2016 Jul 4.

The Association Between Small Dense Low Density Lipoprotein and Coronary Artery Disease in North Indian Patients

Pravin K Goel  1 , Fauzia Ashfaq  1 , Roopali Khanna  1 , V Ramesh  2 , Chandra Mohan Pandey  3
Affiliations

The Association Between Small Dense Low Density Lipoprotein and Coronary Artery Disease in North Indian Patients

Pravin K Goel et al. Indian J Clin Biochem. 2017 Jun.

Abstract

Pathogenesis of coronary artery disease (CAD) is multi-factorial and several conventional risk factors have been ascribed; LDL-C being one of the important risk factor. However Indian population studies with established CAD often show LDL levels within normal range in patients with proven CAD. We hypothesized that Small dense low density lipoprotein (sdLDL) being more atherogenic might correlate more strongly to the occurrence and severity of CAD. The aim of the study was to evaluate the association between serum small dense LDL level and angiographically documented coronary artery disease. This is a cross sectional case control study in which sdLDL were measured in 126 patients with CAD and in 64 patients without CAD. Total cholesterol, HDL Cholesterol, LDL cholesterol and triglycerides were measured by standard methods along with other traditional risk factors. Direct quantitative measurement of sdLDL was done by enzymatic analysis. Mean sdLDL level was higher in patients with coronary stenosis than patients without coronary stenosis (16.3 ± 6.8 vs. 10.1 ± 5.7 mg/dL respectively, (p < 0.001). There was significant correlation between mean sdLDL and severity of CAD as assessed by syntax score with mean sdLDL level in low, intermediate and high syntax score being 15.0 ± 5.8, 20.1 ± 6.7 and 22.7 ± 7.3 mg/dL respectively (p value <0.001). A cut off value of 10.02 mg/dL was associated with presence of CAD (95 % CI 0.82-0.93, p < 0.001) using ROC curve. In conclusion Indian patients with established CAD have higher sdLDL levels compared to individuals without CAD despite having comparable LDL levels.

Keywords: Coronary artery disease; Fasting lipid profile; LDL sub fractions; Lipid metabolism; sdLDL.

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Conflict of interest statement

There is no conflict of interests.

Figures

Fig. 1
Fig. 1
Graded and incremental levels of mean sdLDL according to severity of coronary artery disease as assessed by syntax score
Fig. 2
Fig. 2
Receiver operating characteristics (ROC) curve for predicting presence of coronary artery disease, using data from the case-control cross-sectional study described
See this image and copyright information in PMC

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