RESUMO
BACKGROUND: Abnormal lipids are an important risk factor for development of Coronary Artery Disease, significant patients have normal lipid profile and yet develop CAD. Apolipoproteins B, Apolipoproteins A and their ratio have been shown to be better predictor of risk of developing Coronary artery disease. OBJECTIVE: Assess the Apo B / Apo A ratio with coronary artery disease in patients with normal lipid profile. METHODS AND RESULTS: In 4232 patients with history of CAD 3724(88 %) had abnormal apo b / apo a ratio. Of 2920 patients with normal LDL levels (<100 mg), 2454 patients had abnormal apob/apoa ratio of which 2200 (91%) had CAD. In 1946 patients on lipid lowering agents 1819 had abnormal apo b/ apo a ratio and all had CAD. CONCLUSION: This study ascertains the importance Apo B, Apo A ratio over conventional lipid profile values for predicting CAD and its severity. Apo B/ Apo A ratio and CAD was found to be significant in patients with normal LDL, even in patients with history of dyslipidemia on statins this ratio was significant. Statins have been effective in lowering LDL, but have not shown changes in Apo B levels. Apo B and Apo A should be used to assess the atherogenic potential of lipid disorders.
RESUMO
BACKGROUND: CHADS2 and CHA2DS2-VASc scores have been used for assessing prognostic risk of thromboembolism in non valvular atrial fibrillation patients. They include similar risk factors for the development of CAD To increase the likelihood of determining CAD severity, the CHA2DS2-VASc-HS and CHA2DS2-VASc-HSF score comprising of hyperlipidemia, smoking and family history respectively in addition to the components of the CHA2DS2-VASc score and male instead of female gender. The aim was to investigate whether these risk scores can be used to predict CAD severity. METHODS AND RESULTS: A total of 2976 consecutive patients who underwent coronary angiography were enrolled in the study. Presence of >50% stenosis in a coronary artery was assessed as significant CAD. Of the patients,804 had normal coronary angiograms and served as group 1. The remaining 2172 patients with coronary stenosis were further classified into 2 groups according to CAD with stenosis of <50% or >50%: 834 patients with mild CAD as group 2 and 1338 patients with severe CAD as group 3. The scores were significantly different among the 3 groups. All the four scores correlated significantly with the number of diseased and the Gensini score. CONCLUSION: CHADS2, CHA2DS2-VASc, and especially CHA2DS2-VASc-HS and CHA2DS2-VASc-HSF scores could be considered predictive of the risk of severe CAD with CHA2DS2-VASc-HSF the best scoring scheme to predict CAD severity. The risk scoring systems may play an important role as predictive models because they are simple and can be easily applied by physicians without any additional costs in routine practice.
