Are apolipoproteins A and B better than lipoproteins for assessing risk of obstructive coronary heart disease?

Abstract

Objective -To evaluate whether apolipoproteins A-I (Apo A-I) and B (Apo B) have, higher ensitivity (SN), specificity (SP) and positive predictive value (PPV) than lipoproteins (LP), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triglycerides (TGL) in assessing the risk of coronary heart disease (CHD). Methods - TC: R$ 9.94; HDL: R$ 21.30; LDL: R$ 28.40; TGL: R$ 14.20. One of the major scientific contributions to cardiology in the last 40 years has been the identification of risk factors for coronary heart disease (CHD). One of these risk factors, elevated serum levels of cholesterol and other lipids, plays a major role in atherogenesis and its clinical manifestations. It was demonstrated that high density lipoprotein (HDL) cholesterol acts as an attenuating agent in atherosclerosis, whereas low density lipoprotein (LDL) cholesterol acts as an accelerator of that process and of clinical instability [1][2][3][4][5][6][7][8][9][10][11][12][13] . This knowledge allowed the adoption of measurable criteria for assessment of the risk of ischemic heart disease, using serum lipoprotein levels. These systematic experiences provided clinical trials that have aimed to reduce total cholesterol (TC) and LDL, and to increase HDL with thousands of patients. These trials showed that preventive measures to reduce cholesterol, with or without medication, significantly reduced clinical events and increased the possibility of reducing the atherosclerotic plaque [14][15][16][17][18][19][20][21][22] . The encouraging results of these investigations allowed the development of more specific research on other serum proteins. Among these, the investigation of apolipoproteins A (Apo A-I) and B (Apo B) aimed to the identification of more sensitive and/or more specific parameters for the prediction of the risk of ischemic heart disease stand out . The results of this research disclosed discrepancies among the different centers conducting these studies. Some studies demonstrated that only Apo B was related to CHD while others showed that only Apo A-I was. In regard to the degree of sensitivity (SN) and specificity (SP), the different results also showed discrepancies. Conclusion -Levels of Apo A-I andBased on those previous studies, we designed this study with the following aims: 1) to assess the mean value of serum apolipoproteins in our population; 2) to evaluate whether Apo A-I or Apo B levels were higher in patients with CHD; 3) to compare SN, SP and the positive predictive value (PPV) of apolipoproteins with those of other lipids; 4)

Increased Pro-Thrombotic Platelet Activity Associated with Thrombin/PAR1-Dependent Pathway Disorder in Patients with Secondary Progressive Multiple Sclerosis

“…One of the potential biomarkers of atherosclerosis analyzed in this work is ApoA1, the major protein constituent of the plasma HDL complex. Epidemiologic studies have confirmed that reduced levels of HDL and ApoA1 have a pro-atherogenic effect [ 65 , 66 , 67 ]. Our analysis showed for the first time that the relative expression of mRNA transcripts for the APOA1 gene was significantly lower both in platelets and megakaryocytes from SP MS patients compared to the control group ( Figure 4 A,B).…”