The Effect of Different Lipoproteins on the Severity of Coronary Atherosclerosis and Relation between them in Patients in Kurdistan

Marewan Hawil  Saka; Abdulsatar Kamil  Faeq

doi:10.56056/amj.2018.67

Authors

Marewan Hawil Saka Lecturer in Department of Medicine College of Medicine HMU, Interventional cardiologist at Erbil Cardiac Center
Abdulsatar Kamil Faeq Lecturer in Department of Medicine College of Medicine HMU, Trainee in interventional cardiology Erbil Cardiac Center

DOI:

https://doi.org/10.56056/amj.2018.67

Keywords:

Coronary atherosclerosis, Non high density lipoprotein, Syntax score

Abstract

Background and objectives: Lipoproteins mainly LDL-C and Non HDL-C are among important risk factors for coronary atherosclerosis, Coronary angiography is the standard diagnostic investigation for obstructive coronary vascular disease. Finding a lipoprotein index for severity of coronary atherosclerosis which can be estimated by many score systems is matter of debate among many studies. The objective of the study is to assess the effects of different lipoproteins on severity of coronary atherosclerosis and the relation among them.

Methods:From 1-4-2017 to 28- 2-2018, 125 patients collected in Cardiac Center in Erbil were included in this case control study, the patients were collected on daily base by systematic sampling, for all patients basic demographic data collected including age, gender, ethnic group, if he used statin for more than 3 weeks, the risk factors of atherosclerosis , then standard diagnostic coronary angiography done and fasting total serum cholesterol, low density lipoprotein-C, high density lipoprotein-C, serum triglyceride and non-high density lipoprotein-C were estimated, the severity of coronary atherosclerosis were estimated by Syntax score available on line (http://syntaxscore.com/calculator/start.htm), patients were divided to three groups according to their score levels, the data analyzed by SPSS program.

Results : The study showed that there were no significant differences in the demographic data among the three groups apart from the risk factors, mean ages were (57±11, 59±10 and 61±9 year respectively p-value 0.152), male/female ratio were ( 20/20, 36/8 and31/10 respectively p-value 0.558), The study showed that statins significantly reduced cholesterol (p-value 0.03) and low density lipoprotein ( p-value < 0.001) (albeit above target levels) but they did not reduce significantly the non- high density lipoprotein level ( p-value 0.07) nor they reduced the score values significantly ( p-value 0.32). There was significant positive correlation between high density lipoprotein level and the severity of coronary atherosclerosis in all arms.

Conclusions:Serum level of non-high density lipoprotein is more important than low density lipoprotein as far as severity of coronary atherosclerosis is concerned and target LDL level was not achieved

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References

Nicholas A B, Nicki R C, Brian R W, John A A. Davidson›s principals and practice of medicine. 20th ed. London: Churchill Livingstone; 2006. P 578-80.

Eric J, Robert M, Eric N, James D, Paul D. Text book of cardiovascular medicine. 3rd ed. USA: Lippincott Williams and Wilkins; 2006. P. 19-27.

Eugene B, Robert O B, Douglas L M, Douglas P Z, Peter L. Braunwalds heart disease a text book in cardiovascular medicine. 10th ed. China: Elsevier; 2015. P. 1049-86.

Dennis L, Anthony S, Dan L, Eugene B, Stephen L, Jameson J. Harrison’s principals of internal medicine.16th ed. New York: McGraw- Hill; 2005. P 1425-33.

Eder Q, Scott M Ahrens J. Effects of dietary cholesterol on the regulation of total body cholesterol in man, Journal of lipid research. 1971; 12: 233.

Goldstein J, Brown M. The cholesterol quartet. Science. 2001; 292:1310.

Fauzia A, Goel P, Nagraja M, Rishi S, Mohammed I, Mohammed Z. Lipoprotein (a) and SYNTAX Score Association with Severity of Coronary Artery Atherosclerosis in North India. Sultan Qaboos Univ Med J. 2012; 12(4): 465–72.

Penalva R, Huoya M; Correia L; Feitosa G; Ladeia M. Lipid profile and intensity of atherosclerosis disease in acute coronary syndrome. Arq. Bras Cardiol. 2008;90 (1): 24-9.

Cenk C, Burak A, Baris O. Lipid variables related to the extent and severity of coronary artery disease in non-diabetic Turkish Cypriots. Iran Journal of Public Health. 2015; 44(9): 1196–203.

Jung L, Yuan L, Jian J. Plasma free fatty acids in relation with the severity of coronary artery disease in non-diabetics: A Gensini score assessment. International journal of cardiology, metabolism and endocrine. 2017; 14:48-52.

Michael F, Paul J, Ian H, Richard W. Lipoprotein predictors of the severity of coronary artery disease in men and women. Circulation. 1985; 5:881-8.

Jan J, Lars A, Christian L, Anders H. High Density Lipoproteins and Coronary Atherosclerosis A Strong Inverse Relation With The Largest Particles Is Confined to Normo-triglyceridemic Patients. Atherosclerosis and thrombosis. 1991; 11:174-82.

Jenkins P, Harper R, Nestel P. Severity of coronary atherosclerosis related to lipoprotein concentration. British Medical Journal. 1978; 2:388-91.

Leonardo R, Giuesppe B, Antonio C. Non HDL-C versus LDL-C in predicting coronary atherosclerosis. Heart Lung and Circulation. 2016; 25:953-4. https://doi.org/10.1016/j.hlc.2016.06.790.

Piepoli M, Hoes A, Agewall S et al. European Guidelines on cardiovascular disease prevention in clinical practice: The sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice. Eur Heart J. 2016; 37(29):2315-81.

Camelia S, Anca S, Nicolae S. Statins: mechanism of action and effects. Cell. Mol. Med. 2001;5(4): P.378-87.

Morton K. What is Syntax score and how it›s used? Cath Lab Digest 2009; 17 (8): «Available from» http://www.cathlabdigest.com/articles/ What-SYNTAX-Score-and-How-Should-We-Use-It.

Morton JK. The cardiac catheterization handbook. 4th ed. USA: Mosby; 2003. P. 1-36.

Donalds H, William G. Grossmans cardiac catheterization, angiography and intervention. 6th ed. USA: Lippincott Williams and Wilkins Publisher; 2000. p. 20-35.