Lipid parameters in patients with acute coronary syndromes versus stable coronary artery disease

Eur J Clin Invest. 2015 Oct;45(10):1092-7. doi: 10.1111/eci.12513. Epub 2015 Sep 13.

Abstract

Background: Differences in lipid parameters between patients with acute coronary syndromes (ACS) and patients with stable coronary artery disease (CAD) are unclear and are addressed in this study.

Methods: We enrolled 582 patients with angiographically proven stable CAD (of whom 26·9% had diabetes mellitus type 2 (T2DM)) and 182 patients with ACS (of whom 35·8% had T2DM).

Results: HDL cholesterol and apolipoprotein A1 levels were significantly lower in patients with ACS than in patients with CAD (46 ± 16 mg/dL vs. 50 ± 16 mg/dL, P < 0·001, and 139 ± 30 mg/dL vs. 155 ± 31 mg/dL, P < 0·001, respectively). Analysis of covariance (ancova) adjusting for age, gender, smoking, BMI, statin therapy, alcohol use, hypertension and diabetic state confirmed an independent impact of ACS on HDL cholesterol and apolipoprotein A1 levels (F = 24·1; P < 0·001). In contrast, total cholesterol, LDL cholesterol, non-HDL cholesterol and apolipoprotein B levels did not differ significantly between patients with ACS and patients with stable CAD.

Conclusion: HDL cholesterol and apolipoprotein A1 levels are lower in patients with ACS than in patients with stable CAD.

Keywords: Acute coronary syndrome; HDL cholesterol; apolipoprotein; coronary artery disease; lipid parameters; type 2 diabetes.

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / drug therapy
  • Aged
  • Analysis of Variance
  • Apolipoprotein A-I / metabolism
  • Apolipoproteins B / metabolism
  • Case-Control Studies
  • Cholesterol, HDL / metabolism
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / drug therapy
  • Diabetes Mellitus, Type 2 / blood
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypercholesterolemia / blood
  • Hypertension / blood
  • Lipid Metabolism / physiology*
  • Male
  • Middle Aged
  • Sex Characteristics
  • Triglycerides / metabolism

Substances

  • Apolipoprotein A-I
  • Apolipoproteins B
  • Cholesterol, HDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Triglycerides