Fractional Esterification Rate of Cholesterol and Ratio of Triglycerides to HDL-Cholesterol Are Powerful Predictors of Positive Findings on Coronary Angiography

We examined the predictive value of various clinical and biochemical markers for angiographically defined coronary artery disease (aCAD). Specifically, we assessed the value of the ratio of plasma triglyceride (TGs) to HDL-cholesterol (HDL-C) and the fractional esterification rate of cholesterol in...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 2003-11, Vol.49 (11), p.1873-1880
Main Authors: Frohlich, Jiri, Dobiasova, Milada
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Apolipoproteins
Atherosclerosis
Biological and medical sciences
Biomarkers - blood
Body mass index
Cardiovascular disease
Cardiovascular system
Cholesterol
Cholesterol - blood
Cholesterol - metabolism
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Coronary Angiography
Coronary Artery Disease - blood
Coronary Artery Disease - diagnosis
Coronary Artery Disease - diagnostic imaging
Coronary vessels
Diabetes
Esterification
Female
High density lipoprotein
Humans
Investigative techniques, diagnostic techniques (general aspects)
Laboratories
Lipids
Low density lipoprotein
Male
Medical imaging
Medical sciences
Middle Aged
Multivariate Analysis
Particle size
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Plasma
Predictive Value of Tests
Regression Analysis
Triglycerides
Triglycerides - blood
Vein & artery diseases
Women
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Summary:We examined the predictive value of various clinical and biochemical markers for angiographically defined coronary artery disease (aCAD). Specifically, we assessed the value of the ratio of plasma triglyceride (TGs) to HDL-cholesterol (HDL-C) and the fractional esterification rate of cholesterol in plasma depleted of apolipoprotein B (apoB)-containing lipoproteins (FER(HDL)), a functional marker of HDL and LDL particle size. Patients (788 men and 320 women) undergoing coronary angiography were classified into groups with positive [aCAD(+)] and negative [aCAD(-)] findings. Patient age, body mass index, waist circumference, blood pressure (BP), medications, drinking, smoking, exercise habits, and plasma total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-unesterified cholesterol, HDL-C, TGs, FER(HDL), apoB, log(TG/HDL-C), and TC/HDL-C were assessed. Lipids and apoproteins were measured by standard laboratory procedures; FER(HDL) was determined by a radioassay. Members of the aCAD(+) group were older and had a higher incidence of smoking and diabetes than those in the aCAD(-) group. The aCAD(+) group also had higher TG, apoB, FER(HDL), and log(TG/HDL-C) and lower HDL-C values. aCAD(+) women had greater waist circumference and higher plasma TC and TC/HDL-C. aCAD(+) men, but not women, had higher plasma LDL-C. In the multivariate logistic model, the significant predictors of the presence of aCAD(+) were FER(HDL), age, smoking, and diabetes. If only laboratory tests were included in the multivariate logistic model, FER(HDL) appeared as the sole predictor of aCAD(+). Log(TG/HDL-C) was an independent predictor when FER(HDL) was omitted from multivariate analysis. FER(HDL) was the best laboratory predictor of the presence of coronary atherosclerotic lesions.
ISSN:0009-9147
1530-8561
DOI:10.1373/clinchem.2003.022558