Small LDL-Cholesterol is Superior to LDL-Cholesterol for Determining Severe Coronary Atherosclerosis

Aim: Recent evidence suggests that small dense low-density lipoprotein (sd-LDL) particles are more atherogenic than large-LDL in spite of their lower cholesterol content. This study aimed to determine whether sd-LDL-cholesterol (sd-LDL-C) is superior to LDL-C as a biomarker of coronary heart disease...

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Published in:Journal of Atherosclerosis and Thrombosis 2008, Vol.15(5), pp.250-260
Main Authors: Koba, Shinji, Yokota, Yuuya, Hirano, Tsutomu, Ito, Yasuki, Ban, Yoshihisa, Tsunoda, Fumiyoshi, Sato, Takatoshi, Shoji, Makoto, Suzuki, Hiroshi, Geshi, Eiichi, Kobayashi, Youichi, Katagiri, Takashi
Format: Article
Language:English
Subjects:
Adult
Aged
Apolipoprotein
Biomarkers - blood
Case-Control Studies
Cholesterol, LDL - blood
Coronary Artery Disease - blood
Coronary Artery Disease - diagnosis
Coronary Disease - blood
Coronary Disease - diagnosis
Coronary heart disease
Female
High-sensitivity CRP
Humans
LDL particle size
Male
Middle Aged
Particle Size
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Summary:Aim: Recent evidence suggests that small dense low-density lipoprotein (sd-LDL) particles are more atherogenic than large-LDL in spite of their lower cholesterol content. This study aimed to determine whether sd-LDL-cholesterol (sd-LDL-C) is superior to LDL-C as a biomarker of coronary heart disease (CHD). Methods: LDL particle size determined by gradient gel electrophoresis and sd-LDL-C concentrations quantified by heparin-magnesium precipitation were compared between 482 stable CHD patients and 389 non-diabetic subjects without CHD who were not receiving any lipid-lowering drugs. Results: Both male and female CHD patients had significantly smaller LDL particles and lower large-LDL-C concentrations (estimated by subtracting the sd-LDL-C concentration from the LDL-C concentration), and significantly higher sd-LDL-C concentrations than the control subjects. LDL-C concentrations were modestly higher and sd-LDL-C concentrations were significantly higher in 258 patients with angiographically documented severe CHD than in the patients with mild CHD irrespective of treatment by LDL-lowering drugs and history of myocardial infarction and/or coronary revascularization. Large-LDL-C concentrations, in contrast, were similar between the two groups. Multivariate logistic regression analysis revealed that sd-LDL-C levels were significantly associated with severe CHD independently of LDL-C. Conclusion: sd-LDL-C levels are more powerful than LDL-C levels for the determination of severe stable CHD.
ISSN:1340-3478
1880-3873
DOI:10.5551/jat.E572