Assessment of Risk Stratification and Prognosis among Patients of AMI by Lipoprotein (A), Lipid Profile and Antioxidant Biomarkers
Authors/Creators
- 1. Associate Professor, Department of Biochemistry, SRVS Medical College, Shivpuri, M.P., India
- 2. Assistant Professor, Department of Community Medicine, SRVS Medical College, Shivpuri, M.P.
- 3. Associate Professor, Department of Pharmacology, SRVS Medical College, Shivpuri, M.P.
Description
Introduction: Acute myocardial infarction (AMI) is one of the important reasons for morbidity and mortality in the world. Indians are more prone to coronary artery disease (CAD) at a much younger age. Lipoprotein (a) [Lp (a)] levels have revealed wide ethnic variations. Lp(a) levels show link with clinical variables and severity of AMI in Gwalior region of India population needed further studies. The aim is to study and evaluate the alteration of lipid profile and lipoprotein (a) in AMI and compare it with that of a healthy population mainly in Gwalior region in India. Methodology: Case control studies involving 100 patients of AMI were taken as cases and 100healthy persons were used as controls almost same age and sex matched. They were analysed by measurement of various parameters like BP, biochemical parameters such as FBS, lipid profile, MDA, GPx, SOD and catalase enzymes and Lipoprotein (a). Serum Lp(a) estimation was performed by immunoturbidimetric method. Results: Our findings and evaluation demonstrated that elevated values of FBS, total cholesterol, triglycerides, LDL-c, VLDL-c and Lp(a) level and decreased level of HDL-c and antioxidant enzymes (GPx, SOD and catalase) were observed in AMI subjects. Concentration of Lp(a) was significantly higher in AMI subjects (43.66±8.20) in comparison to control subjects (22.9±03.46).The values of all biochemical markers were found increased in AMI patients and the difference were found to be statically significant. The level of Lp (a) and Lipid profile were found positive correlation in AMI. Conclusion: Our study showed the patients of acute myocardial infarction have increased levels of serum Lp(a) as compared to healthy individuals. The increased level of serum lipoprotein(a) is strongly linked with the risk of coronary heart disease.
Abstract (English)
Introduction: Acute myocardial infarction (AMI) is one of the important reasons for morbidity and mortality in the world. Indians are more prone to coronary artery disease (CAD) at a much younger age. Lipoprotein (a) [Lp (a)] levels have revealed wide ethnic variations. Lp(a) levels show link with clinical variables and severity of AMI in Gwalior region of India population needed further studies. The aim is to study and evaluate the alteration of lipid profile and lipoprotein (a) in AMI and compare it with that of a healthy population mainly in Gwalior region in India. Methodology: Case control studies involving 100 patients of AMI were taken as cases and 100healthy persons were used as controls almost same age and sex matched. They were analysed by measurement of various parameters like BP, biochemical parameters such as FBS, lipid profile, MDA, GPx, SOD and catalase enzymes and Lipoprotein (a). Serum Lp(a) estimation was performed by immunoturbidimetric method. Results: Our findings and evaluation demonstrated that elevated values of FBS, total cholesterol, triglycerides, LDL-c, VLDL-c and Lp(a) level and decreased level of HDL-c and antioxidant enzymes (GPx, SOD and catalase) were observed in AMI subjects. Concentration of Lp(a) was significantly higher in AMI subjects (43.66±8.20) in comparison to control subjects (22.9±03.46).The values of all biochemical markers were found increased in AMI patients and the difference were found to be statically significant. The level of Lp (a) and Lipid profile were found positive correlation in AMI. Conclusion: Our study showed the patients of acute myocardial infarction have increased levels of serum Lp(a) as compared to healthy individuals. The increased level of serum lipoprotein(a) is strongly linked with the risk of coronary heart disease.
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IJPCR,Vol15,Issue5,Article54.pdf
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Additional details
Dates
- Accepted
-
2023-04-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue5,Article54.pdf
- Development Status
- Active
References
- 1. Camm AJ. Cardiovascular disease. In: Kumar P, Clark M, editors. Clinicalmedicine. 5th ed. London: Bath Press; 2002; 766-83. 2. Lowry PJ, Glover DR, Mace PJ, Littler WA. Coronary artery disease in Asians in Birmingham'. Br Heart J. 1984;52(6):610-3. 3. Gambhir JK, Kaur H, Gambhir DS, Prabhu KM. Lipoprotein(a) as an independent risk factor for coronary artery disease in patients below 40 years of age. Indian Heart J. 2000;52(4):411-5. 4. Hopkins PN, Wu LL, Hunt SC, James BC, Vincent GM, Williams RR. Lipoprotein(a) interactions with lipid and nonlipid risk factors in early familial coronary artery disease. Arterioscler Thromb Vasc Biol. 1997;17(11):2783-92. 5. Perk J, De Backer GD, Gohlke H, Graham I, Reiner Z, Verschuren WMM et al. 'European guidelines on cardiovascular disease prevention in clinical practice (version 2012): the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Int J Behav Med. 2012;19(4):403-88. 6. 'Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52. 7. Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Clin Periodontol. 2013;40; Suppl 51. 8. Enas EA, Yusuf S, Mehta JL. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol. 1992;70(9):945-9. 9. Tselepis AD, Elisaf M, Goudevenos J, Tselegaridis T, Bairaktari E, Siamopoulos KC et al. Lipid profile in patients with microvascular angina. 'Eur J Clin Invest'. 1996;26(12):1150- 55. 10. Miwa K, Nakagawa K. discriminate 'high- risk' from 'low-risk' Japanese patients with coronary artery disease'. Jpn Circ J. 2000;64(11):825-30. 11. Berg K. A NEW SERUM TYPE SYSTEM IN MAN-THE Lp SYSTEM. Acta Pathol Microbiol Scand;59(3):369-82. 12. Li Y, Luke MM. Shiftman D et al. Genetic variants in the apolipoprotein (a) gene and coronary heart disease. Circ Cardiovasc Genet. 2011; 4:565. e573. 13. Kronenberg F, Utermann G. Lipoprotein (a): resurrected by genetics. J Intern Med. 2013; 273:6. e30. 14. Helgadottir A, Gretarsdottir S, Thorleifsson G, Holm H, Patel RS, Gudnason T, et al. Apolipoprotein(a) Genetic Sequence Variants Associated with Systemic Atherosclerosis and Coronary Atherosclerotic Burden but Not with Venous Thromboembolism. J Am Coll Cardiol. 2012;60(8):722-9. 15. Schwartzman RA, Cox ID, Poloniecki J, Crook R, Seymour CA, Kaski JC. Elevated plasma lipoprotein(a) is associated with coronary artery disease in patients with chronic stable angina pectoris. J Am Coll Cardiol. 1998;31(6):1260-6. 16. Murai A, Miyahara T, Fujimoto N, Matsuda M, Kameyama M. Lp(a) lipoprotein as a risk factor for coronary heart disease and cerebral infarction. Atherosclerosis. 1986;59(2):199-204.17. DeWood MA, Spores J, Notske R, Mouser LT, Burroughs R, Golden MS et al. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med. 1980;303(16):897-902. 18. Marcovina SM. Albers JJ and Gabel Bet al. Effect of the number of apolipoprotein (a) kringle 4 domains on immunochemical measurements of lipoprotein (a). Clin Chem. 1995; 41:246. e255. 19. Marcovina SM, Koschinsky ML, Albers JJ, Skarlatos S. Report of the National Heart, Lung, and Blood Institute Workshop on Lipoprotein(a) and cardiovascular disease: recent advances and future directions. Clin Chem. 2003;49(11):1785-96. 20. Morrisett JD. The role of lipoprotein[a] in atherosclerosis. Curr Atheroscler Rep. 2000;2(3):243-50. 21. Morishita R, Ishii J, Kusumi Y, Yamada S, Komai N, Ohishi M et al. Association of serum oxidized lipoprotein(a) concentration with coronary artery disease: potential role of oxidized lipoprotein(a) in the vascular wall'. J Atheroscler Thromb. 2009;16(4):410-8. 22. Xue S, Madison EL, Miles LA. The Kringle V-protease domain is a fibrinogen binding region within Apo(a). Thromb Haemost. 2001;86(5):1229-37. 23. Sandkamp M, Funke H, Schulte H, Köhler E, Assmann G. Lipoprotein(a) is an independent risk factor for myocardial infarction at a young age. Clin Chem. 1990;36(1):20-3. 24. DeySarkar P, Ramprasad N, Dey Sakar, Shivaprakash TM. Study of oxidative stress and trace elements levels in patients with alcoholic and nonalcoholic coronary artery disease. Indian J Phys Pharmacol. 2007; 51:141-6. 25. Shinde S, Kumar P, Patil N. Decreased levels of erythrocyte glutathione in patients with myocardial infarction. Internet J Altern Med. 2004; 2:1-4. 26. Patil N, Chavan V, Karnik ND. 'Antioxidant status in patients with acute myocardial infarction'. Indian J Clin Biochem. 2007;22(1):45-51. 27. Gerritsen WB, van Boven WJ, Boss DS, Haas FJ, van Dongen EP, Aarts LP. Malondialdehyde in plasma, a biomarker of global oxidative stress during mini-CABG compared to onand off-pump CABG surgery: a pilot study'. Interact Cardiovasc Thorac Surg. 2006;5(1):27-31. 28. Halliwell B. Tell me about free radicals, doctor: a review.J R Soc Med. 1989;82(12):747-52. 29. Motghare KS, Bhutey A, Murrhar BB, Gupta M, Meshram AW, Balsubramanium Y. Lipid peroxidation and glutathione peroxidase in ischemic heart disease. Indian J Clin Biochem. 2001; 16:213- 5. 30. Blankenberg S, Rupprecht HJ, Bickel C, Torzewski M, Hafner G, Tiret L, et al. Glutathione peroxidase 1 activity and cardiovascular events in patients with coronary artery disease'. N Engl J Med. 2003;349(17):1605-13. 31. Schnabel R, Lackner KJ, Rupprecht HJ, Espinola-Klein C, Torzewski M, Lubos E. Glutathione peroxidase-1 and homocysteine for cardiovascular risk prediction: results from the AtheroGene study'. J Am Coll Cardiol. 2005;45(10):1631-7.