Oxidised LDL Cholesterol (Ox-LDL-C) and Ox-LDL-C/HDL Cholesterol (HDL-C) Ratio in Acute Coronary Syndrome Patients versus Chronic Coronary Artery Disease Patients on Statin Treatment BC14-BC17
Dr. Deepti Girija Nandakumaran,
Associate Professor, Department of Biochemistry, Believers Church Medical College Hospital, Thiruvalla-689103, Kerala, India.
Introduction: Oxidised Low Density Lipoprotein Cholesterol (Ox-LDL-C) and High Density Lipoprotein Cholesterol (HDL-C) have antagonistic action in the development of atherosclerotic cardiovascular disease. Use of statins reduces cardiovascular risk by reducing LDL-C levels and also by increasing HDL-C. No systematic studies were carried out to study the role of HDL-C as an antioxidant and its effect in decreasing Ox-LDL-C.
Aim: To compare the values of Ox-LDL-C/HDL-C in patients with chronic Coronary Artery Disease (CAD) and patients with Acute Coronary Syndrome (ACS) and to evaluate the levels of Ox-LDL-C and Ox LDL-C/HDL-C ratio in patients treated with the two different statins.
Materials and Methods: In this cross-sectional study 30 patients with ACS and 30 patients with chronic CAD on rosuvastatin or atorvastatin were included in the study. Apparently normal 27 age and sex-matched controls without CAD was included in the study. Lipid profile was estimated using fully auto analyser and Ox-LDL-C was estimated using ELISA kits. Statistical analysis was done using SPSS version 16 software. A p-value of <0.05 was considered as statistically significant.
Results: Hypertension and diabetes were found to be significantly associated with CAD (p-value 0.03). There was significant correlation between total cholesterol, triglycerides, with CAD. The levels of triglycerides, Ox-LDL-C and Ox-LDL-C/HDL-C were significantly higher (p<0.05) in ACS patients compared to chronic CAD and normal. Total cholesterol and LDL-C were lower in chronic CAD patients on atorvastatin treatment compared to patients on rosuvastatin treatment.
Conclusion: Ox-LDL-C/HDL-C ratio is a better predictor of acute coronary events. In addition to lipid lowering action, statins have pleiotropic benefits including prevention of LDL oxidation.