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  • Title: HDL subpopulations containing apoA-I without apoA-II (LpA-I) in patients with angiographically proven coronary artery disease.
    Author: Kuchta A, Strzelecki A, Ćwiklińska A, Gruchała M, Zdrojewski Z, Kortas-Stempak B, Wieczorek E, Gliwińska A, Dąbkowski K, Jankowski M.
    Journal: J Cardiol; 2017 Mar; 69(3):523-528. PubMed ID: 27169356.
    Abstract:
    BACKGROUND: High density lipoproteins (HDL) can be divided into two metabolically distinct fractions, one containing apolipoprotein (Apo) A-I but not ApoA-II [apolipoprotein A-I; lipoprotein (Lp) A-I] and the other containing both ApoA-I and ApoA-II (LpA-I/A-II). LpA-I fraction which, seeming to be more cardioprotective than LpA-I/A-II particles, is itself heterogeneous. Preβ1-HDL is a minor subfraction of LpA-I and the initial acceptor of cellular cholesterol in the process of reverse cholesterol transport. The aim of the study was to determine the usefulness of the determination of LpA-I fractions as indicators for the atherosclerotic process. METHODS: The study included 112 patients with angiographically-documented coronary artery disease (CAD+) and 51 patients with negative results of coronary angiography (CAD-). We evaluated LpA-I concentration in serum in HDL2 and HDL3 fractions as well as Preβ1-HDL concentration. Furthermore, we analyzed the association of the assessed parameters with the extent and severity of CAD assessed by Gensini score. RESULTS: CAD+ patients were characterized by a lower concentration of serum LpA-I by 19%, LpA-I in HDL2 by 26%, higher level of Preβ1-HDL by 27%, and elevated Preβ1-HDL/LpA-I values by 62%. Univariate correlation analysis indicated that serum LpA-I and HDL-cholesterol concentrations were negatively correlated with Gensini score (R=-0.279; p=0.002, R=-0.227; p=0.016, respectively) whereas Preβ1-HDL/LpA-I values were positively correlated with the severity of CAD (R=0.529; p<0.001). In multiple linear regression, after adjusting for age, gender, preexisting hypertension, diabetes, and statin therapy, only the Preβ1-HDL/LpA-I values remained an independent determinant of atherosclerosis severity (β=-0.499; p<0.001). CONCLUSIONS: Our results show a lower level of LpA-I and higher concentration of Preβ1-HDL in the CAD+ patients compared to the CAD- group. We suggest that the distribution of LpA-I is different in CAD and the Preβ1-HDL/LpA-I ratio may have additional value in assessing anti-atherogenic potential of HDL particles and it is likely to become a clinically valuable indicator of atherosclerosis development.
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