Emerging Risk Markers; Nitric Oxide and Oxidized Low-Density Lipoprotein in Predicting Coronary Heart Disease in Young subjects

Abstract

NO is a free radical gas, identified as Endothelial Derived Releasing Factor (EDRF) and synthesized from L-arginine which plays a dynamic role in defence against onset and development of coronary heart disease. Decreased availability of nitric oxide is one of the important cause for the pathogenesis of atherosclerosis. An accumulation of Low Density Lipoprotein cholesterol (LDL) in the intimal wall is the early step in atherosclerosis. Reduced NO level in the endothelium makes it vulnerable and increase the passage of leukocyte and undergo LDL oxidation in the sub endothelial space which ultimately lead to coronary heart disease. The aim of the study is to assess role of Nitric Oxide and oxidized LDL in CHD subjects. This cross-sectional study was conducted in SRM Medical college Hospital and Research centre on subjects attending the Department of Cardiology and Medicine OP. The study was conducted on 194 subjects in age group <40 years and were age and sex matched. After overnight fasting blood samples were collected for analysis for Lipid Profile and Nitric oxide and ox-LDL. Nitric Oxide and ox-LDL measured by ELISA method. Statistical analysis was done using Student‘t’ test and Pearson correlation analysis for the comparison between two groups. The mean level of Nitric Oxide were decreased (12.97± 1.20) significantly in CHD group compared to controls (19.08±4.74) (p <0.001). And Oxidized LDL showed significant increase (41.53± 8.72) in CHD group when compared to controls (16.73± 3.55) (p <0.001). Reduction in the levels of NO in the arterial wall impairs endothelial function. The study concludes that there is a strong association between NO and ox-LDL in progression of CHD. Interestingly, these analyses can help as diagnostic and monitoring markers in young CHD patients.