Lipid and inflammatory markers for the prediction of coronary artery disease: a multi-marker approach.
BACKGROUND
Many studies have investigated the clinical accuracy of single lipid and inflammatory markers. In contrast, few have evaluated their potential for the detection of CAD using a multi-marker approach.


METHODS
The concentrations of lipid, lipoproteins, apolipoproteins, high sensitivity C-reactive protein (hs-CRP) and fibrinogen were measured by standard laboratory methods. Apolipoprotein (a) [apo(a)] phenotyping was performed by sodium dodecylsulphate-gel electrophoresis and immunoblotting. The lipid tetrad index (LTI) and the lipid pentad index (LPI) were calculated. Clinical accuracy of the examined parameters, indexes and a logistic regression model was assessed using receiving operative characteristic (ROC) curve analysis.


RESULTS
Logistic regression analysis indicated that non-HDL-c, hs-CRP, HDL-c and Lp(a) were significant independent predictors for CAD. The AUC for this model (0.802) was higher than AUCs for any single marker or index tested.


CONCLUSIONS
We conclude that the performance of a logistic regression model for CAD prediction warrants its use in clinical practice.
Bogavac-Stanojević
Natasa
N
Institute of Medical Biochemistry, Faculty of Pharmacy, POB 146, 11000 Belgrade, Serbia.
Jelić-Ivanović
Zorana
Z
Spasojević-Kalimanovska
Vesna
V
Spasić
Slavica
S
Kalimanovska-Ostrić
Dimitra
D
D000328:Adult; D001053:Apolipoproteins / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood; D008055:Lipids / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors
D001053:Apolipoproteins; D015415:Biomarkers; D008055:Lipids; D017270:Lipoprotein(a); D005340:Fibrinogen; D002097:C-Reactive Protein