Lp(a), ApoB and ApoB/ApoA1 Ratio as Potential Serum Markers for Predicting Early-Onset Acute Coronary Syndrome

Author(s): Rebecca James, Sandeep Appunni

BACKGROUND Prevalence of coronary artery disease is higher in elderly population (>60 years) however, it is increasingly seen in younger population due to change in lifestyle. Lipoprotein a [Lp(a)], Apolipoprotein B (ApoB) and Apolipoprotein A1 are among the emerging markers for acute coronary syndrome (ACS). Routine lipid profile does not incorporate these markers and cardiovascular diseases (CVD) in young individuals who show marked derangement in their blood biochemical profile. In this study we assessed Lp(a), ApoB, ApoA1 and ApoB/ApoA1 ratio in non-elderly individuals and compared it with routine lipid profile. METHODS This is a cross-sectional study comprising of 75 cases and 69 controls between 15- 55 years of age from whom morning fasting blood samples were collected and analysed for lipid profile, Lp(a), ApoB, ApoA1 and ApoB/ApoA1 ratio. RESULTS We found that all the parameters in routine lipid profile as well as Lp(a), ApoB and ApoB/ApoA1 were significantly elevated in cases compared to controls. However, the risk of developing early onset acute coronary syndrome is high in the presence of non-routine markers like Lp(a) [Odds Ratio (OR)=11.71], ApoB (OR=11.70) and ApoB/ApoA1 (OR=11.74). CONCLUSIONS This study suggests that complementing the traditional lipid profile with ApoB, ApoB/ApoA1 and Lp(a) would be favourable additions for predicting early onset ACS.

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