Small Dense Low-Density Lipoprotein for Risk Prediction of Acute Coronary Syndrome

Abhishek Singh; Rajendra Puhan; Akshyaya Pradhan; Wahid Ali; Rishi Sethi

doi:10.14740/cr1254

Small Dense Low-Density Lipoprotein for Risk Prediction of Acute Coronary Syndrome

Cardiol Res. 2021 Aug;12(4):251-257. doi: 10.14740/cr1254. Epub 2021 Jul 9.

Authors

Abhishek Singh¹, Rajendra Puhan¹, Akshyaya Pradhan², Wahid Ali³, Rishi Sethi²

Affiliations

¹ Department of Internal Medicine, King George's Medical University, Lucknow, Uttar Pradesh 226003, India.
² Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India.
³ Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India.

PMID: 34349867
PMCID: PMC8297045
DOI: 10.14740/cr1254

Abstract

Background: Elevated Low density Lipoprotein (LDL) levels have been traditionally associated with development of atherosclerotic coronary artery disease (CAD). As LDL-cholesterol levels are not always raised in acute coronary syndrome (ACS) patients, sd-LDL is an emerging risk factor. The purpose of the present study was tri-fold. Firstly, it aimed to investigate the association of sd-LDL as a risk factor in ACS patients. Secondly, it aimed to correlate the presence of sd-LDL with severity of coronary artery disease as determined by coronary angiography. Lastly, it aimed to correlate the presence of sd-LDL with short-term outcomes.

Methods: This was a prospective, hospital-based, cross-sectional, case-control study conducted over a 1-year study duration. Patients above the age of 18 years diagnosed with ACS within 24 h of admission were studied. Blood samples were collected after all patients had undergone coronary angiography and sd-LDL levels were measured.

Results: ACS patients had significantly higher sd-LDL levels than non-ACS patients (16.10 ± 1.42 mg/dL vs. 12.67 ± 0.71 mg/dL, P = 0.036). Males had significantly higher sd-LDL levels than females (16.79 ± 1.55 mg/dl vs. 10.77 ± 2.62 mg/dl, P=0.047). Patients with non-left anterior descending coronary artery (LAD) involvement had significantly higher sd-LDL levels compared to patients with LAD involvement (21.92 ± 3.55 mg/dL vs. 14.03 ± 1.35 mg/dL, P = 0.007).

Conclusion: These results suggest that sd-LDL is a risk factor for the development of ACS in an Indian population.

Keywords: Acute coronary syndrome; Coronary artery disease; Left anterior descending coronary artery; Major adverse cardiac events; Small density low-density lipoprotein.