Lipoprotein(a) Is the Best Single Marker in Assessing Unstable Angina Pectoris.

This study evaluated whether statin therapy changed a diagnostic validity of lipid and inflammatory markers in ischemic heart disease (IHD) patients. Levels of lipids, lipoproteins, apolipoproteins, inflammatory markers, and atherogenic indexes were determined in 49 apparently healthy men and women, 82 patients having stable angina pectoris (SAP), 80 patients with unstable angina (USAP), and 106 patients with acute ST-elevation myocardial infarction (STEMI) treated or not treated with statins. Diagnostic accuracy of markers was determined by ROC curve analysis. Significantly lower apoA-I in all statin-treated groups and significantly higher apoB in statin-treated STEMI group compared to non-statin-treated groups were observed. CRP showed the best ROC characteristics in the assessment of STEMI patients. Lp(a) is better in the evaluation of SAP and USAP patients, considering that Lp(a) showed the highest area under the curve (AUC). Regarding atherogenic indexes, the highest AUC in SAP group was obtained for TG/apoB and in USAP and STEMI patients for TG/HDL-c. Statins lowered total cholesterol, LDL-c, and TG but fail to normalize apoA-I in patients with IHD.

Serum Fas/FasL levels in dependence on clinical presentations of coronary disease and their relationship with risk factors.

BACKGROUND/AIM: Ischemic heart disease is mostly a consequence of atherosclerosis. Besides the inflammation, the Fas/Fas ligand (FasL)/caspase death pathway is documented to be activated in atherosclerotic lesions. The aim of this study was to compare the values of soluble forms of Fas and FasL in patients with different presentations of coronary disease and to correlate Fas/FasL with risk factors. METHODS: We studied 30 patients with chronic stable angina pectoris (SAP), 27 with non-stable angina pectoris (NSAP), and 39 with acute ST-elevation myocardial infarction (STEMI) and 27 age-matched healthy volunteers (the control group). Serum Fas/APO1 and FasL concentrations were determined using a commercially available enzyme-linked immunoassays (ELISA). RESULTS: Fas/APO-1 levels in the STEMI patients (6.981 +/- 2.689 ng/mL) were significantly higher than Fas levels in the controls (5.092 +/- 1.252 ng/mL, p < 0.01), but not significantly higher than Fas values in the SAP (5.952 +/- 2.069 ng/mL) and the USAP patients (5.627 +/- 2.270 ng/ml). Levels of FasL did not show any significant difference among the studied groups. In the SAP patients Fas/APO1 showed a significant positive correlation with high sensitivity C-reactive protein (hsCRP) (p < 0.05) and a negative correlation with high-density lipoprotein cholesterol (HDL-C) (p < 0.05), while FasL showed a significant positive correlation with low-density lipoprotein cholesterol (LDL-C) (p < 0.05). Fas levels between the patients having cholesterol within normal range and those whose cholesterol was above the normal range showed a significant difference (p < 0.05) only in the NSAP patients. Fas and FasL levels between the patients with hsCRP lower than 3.0 mg/L and those with hsCRP higher than 3.0 mg/L of the SAP group showed a significant differences (p < 0.001, p < 0.05, respectively). Strong correlation between Fas concentration and diabetes mellitus (p < 0.05) and FasL concentrations and both cholesterol (p < 0.01) and triglycerides (p < 0.01) in the NSAP patients was observed. The patients in the SAP group showed no strong correlation between Fas and FasL concentration and risk factors. CONCLUSIONS: The obtained results showed that apoptotic process is dysregulated in the patients with ischemic heart disease. Interdependence between Fas and FasL and inflammatory and lipid markers as well as with cardiovascular risk factors was established.