Risk Factors, biochemical markers, and genetic polymorphisms in early coronary artery disease.
OBJECTIVE
To assess the risk factors, lipid and apolipoprotein profile, hemostasis variables, and polymorphisms of the apolipoprotein AI-CIII gene in early coronary artery disease (CAD).


METHODS
Case-control study with 112 patients in each group controlled by sex and age. After clinical evaluation and nutritional instruction, blood samples were collected for biochemical assays and genetic study.


RESULTS
Familial history of early CAD (64 vs 39%), arterial hypertension (69 vs 36%), diabetes mellitus (25 vs 3%), and previous smoking (71 vs 46%) were more prevalent in the case group (p<0.001). Hypertension and diabetes were independent risk factors. Early CAD was characterized by higher serum levels of total cholesterol (235 +/-6 vs 209 +/- 4 mg/dL), of LDL-c (154 +/- 5 vs 135 +/- 4 mg/dL), triglycerides (205 +/- 12 vs 143 +/- 9 mg/dL), and apolipoprotein B (129 +/- 3 vs 105 +/- 3 mg/dL), and lower serum levels of HDL-c (40 +/- 1 vs 46 +/- 1 mg/dL) and apolipoprotein AI (134 +/- 2 vs 146 +/- 2mg/dL) [p<0.01], in addition to an elevation in fibrinogen and D-dimer (p<0.02). The simultaneous presence of the rare alleles of the APO AI-CIII genes in early CAD are associated with hypertriglyceridemia (p=0.03).


CONCLUSIONS
Of the classical risk factors, hypertension and diabetes mellitus were independently associated with early CAD. In addition to an unfavorable lipid profile, an increase in the thrombotic risk was identified in this population. An additive effect of the APO AI-CIII genes was observed in triglyceride levels.
Izar
Maria Cristina
MC
Disciplina de Cardiologia, UNIFESP/EPM, Universidade Federal de São Paulo, Sao Paulo, SP. lipides.dmed@unifesp.epm.br
Fonseca
Francisco Antonio Helfenstein
FA
Ihara
Sílvia Saiuli Miki
SS
Kasinski
Nelson
N
Sang
Won Han
WH
Lopes
Ieda Edite Lanzarini
IE
Pinto
Leonor do Espírito Santo de Almeida
Ldo E
Relvas
Waldir Gabriel Miranda
WG
Lourenço
Daisy
D
Tufik
Sérgio
S
de Paola
Angelo Amato Vincenzo
AA
Carvalho
Antonio Carlos Camargo
AC
D000328:Adult; D016632:Apolipoprotein A-I / Q000235:genetics; D053305:Apolipoprotein C-III; D001056:Apolipoproteins C / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology* / Q000235:genetics; D005260:Female; D006487:Hemostasis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012307:Risk Factors
D016632:Apolipoprotein A-I; D053305:Apolipoprotein C-III; D001056:Apolipoproteins C; D015415:Biomarkers; D008055:Lipids