Evaluation of small dense low‐density lipoprotein concentration for predicting the risk of acute coronary syndrome in Chinese population

Abstract

Background Acute coronary syndrome (ACS) is the leading cause of death in developing and developed countries, yet assessing the risk of its development remains challenging. Several lines of evidence indicate that small, dense low‐density lipoproteins (sd‐LDL) are associated with increased cardiovascular disease risk. We aim to evaluate sd‐LDL concentration for predicting the risk of ACS in Chinese population. Methods Baseline characteristics of 121 patients with ACS and 172 healthy controls were obtained. Plasma sd‐LDL‐C was measured using homogeneous assay, and the proportion of sd‐LDL‐C in LDL‐C was detected. Results There was gender and age effect on the sd‐LDL‐C concentration and sd‐LDL‐C/LDL‐C ratio among healthy subjects. Elevated sd‐LDL‐C concentrations and sd‐LDL‐C/LDL‐C ratio were observed in ACS patients with unstable angina pectoris (UAP), non–ST‐segment elevation myocardial infarction (STEMI), and ST‐segment elevation myocardial infarction (NSTEMI) compared with healthy controls (P < .05); however, there were no differences among ACS groups. According to Pearson's correlation coefficient analyses, sd‐LDL‐C concentration and sd‐LDL‐C/LDL‐C ratio were positively correlated with triglyceride (TG) and LDL‐C concentrations (P < .05) and negatively correlated with high‐density lipoprotein (HDL) concentration (P < .05). Based on the receiver operating characteristic (ROC) curves, the cutoff values of sd‐LDL‐C and sd‐LDL‐C/LDL‐C ratio for the prediction of ACS were 1.06 mmol/L and 34.55%, respectively. Multivariate logistic regression analysis demonstrated that the sd‐LDL‐C/LDL‐C ratio, but not sd‐LDL‐C concentration, was significantly associated with ACS events [OR (95% CI): 1.24, 1.11‐1.38, P < .001]. Conclusions The sd‐LDL‐C/LDL‐C ratio may be associated with an increased risk of developing ACS in Chinese population.

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

“…However, ethnical variation, differing methodology, and varying cut-off points should be taken into consideration when attempting to compare precise sd-LDL levels [7][8][9]. Additionally, Wu et al [6] also exposed a gender effect. Sd-LDL levels were higher in males (0.71 ± 0.24 mmol/L) compared to females (0.63 ± 0.22 mmol/L).…”

“…Fukushima et al [ 5 ] showed higher sd-LDL levels for ACS patients (30 ± 14 mg/dL) compared to healthy controls (22 ± 8 mg/dL). Wu et al [ 6 ] observed higher sd-LDL levels for UA patients (male: 1.09 mmol/L and female: 1.03 mmol/L), STEMI patients (male: 1.30 mmol/L and female: 1.17 mmol/L), and NSTEMI patients (male: 1.44 mmol/L and female: 1.14 mmol/L) compared to healthy controls (male: 0.72 mmol/L and female: 0.62 mmol/L). These findings are suggestive of sd-LDL as a risk factor for ACS.…”

2-Arachidonoylglycerol Attenuates Fibrosis in Diabetic Mice via the TGF-β1/Smad Pathway

“…High LDL-C concentration in the serum is one of the major risk factors for coronary heart disease [19,20] .…”

Association of small dense low-density lipoprotein with cardiovascular outcome in patients with coronary artery disease and diabetes: a prospective, observational cohort study

“…Several studies in different populations using various sdLDL measurements suggested that the sdLDL was related to the carotid intima thickness and in association with progression of carotid artery plaque [25][26][27]. Wu et al reported in 2019 that elevated sdLDL concentration was observed in ACS patients (n = 121) but not in healthy controls (n = 172) [28]. In ARIC study (11419 community-based participants and followed-up for 11 years), the plasma sdLDL was measured by an automated homogeneous assay.…”