Improved identification of patients with coronary artery disease by the use of new lipid and lipoprotein biomarkers
Improved identification of patients with coronary artery disease by the use of new lipid and lipoprotein biomarkers
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DOI：
10.1016/j.amjcard.2005.09.123
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发表时间：
2006-03-01
影响因子：
2.8
通讯作者：
Wallentin, L
中科院分区：
文献类型：
--
作者：
Johnston, N;Jernberg, T;Wallentin, L
新的脂类和脂蛋白生物标记物作为冠状动脉疾病的危险因素正受到越来越多的关注，尽管关于这些新的生物标记物用于识别冠状动脉疾病患者的诊断准确性的信息有限。本研究测定了431名无冠心病临床证据的健康男女的总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、脂蛋白相关磷脂酶A2(LP-PLA2)和氧化型低密度脂蛋白/高密度脂蛋白胆固醇的水平。通过测量曲线下面积进行受试者工作特性曲线分析，确定诊断的准确性。各脂质或脂蛋白生物标志物对氧化低密度脂蛋白/高密度脂蛋白胆固醇的诊断准确率为0.867(95%可信区间为0.844~0.890)，氧化低密度脂蛋白为0.826(95%CI为0.800~0.852)，1/高密度脂蛋白为0.775(95%CI为0.745~0.805)，总/高密度脂蛋白为0.764(95%CI为0.733~0.795)，甘油三酯为0.631(95%CI为0.594~0.667)，脂蛋白-磷脂酶A2为0.597(95%CI为0.558至0.615)，低密度脂蛋白为0.577(95%CI为0.539至0.615)，总胆固醇为0.520(95%CI为0.482至0.537)。总而言之，这些发现表明，氧化低密度脂蛋白/高密度脂蛋白胆固醇的比率是一个比传统测量的脂类和脂蛋白以及脂蛋白-PLA2更有效的区分冠心病患者和非冠心病患者的生物标志物。(C)2006 Elsevier Inc.保留所有权利。
Increasing attention is being directed toward new lipid and lipoprotein biomarkers as risk factors for coronary artery disease, although limited information is available on the diagnostic accuracy of these new biomarkers for the identification of patients with coronary artery disease. In the present study, levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, lipoprotein-associated phospholipase A2 (Lp-PLA2), and oxidized LDL/HDL cholesterol were determined in 431 apparently healthy men and women without clinical evidence of coronary artery disease who were matched for age and gender with 490 men and women with coronary artery disease who participated in the Second Fragmin and Fast Revascularization During Instability in Coronary Artery Disease (FRISC-II) trial. Diagnostic accuracy was determined by receiver-operating characteristic curve analysis by measuring the area under the curve. The diagnostic accuracies of each lipid or lipoprotein biomarker (in descending order of area under the curve) were 0.867 for oxidized LDL/HDL cholesterol (95% confidence interval [CI] 0.844 to 0.890), 0.826 for oxidized LDL (95% Cl 0.800 to 0.852), 0.775 for 1/HDL cholesterol (95% CI 0.745 to 0.805), 0.764 for total/HDL cholesterol (95% Cl 0.733 to 0.795), 0.631 for triglycerides (95% Cl 0.594 to 0.667), 0.597 for Lp-PLA2 (95% CI 0.558 to 0.615), 0.577 for LDL cholesterol (95% Cl 0.539 to 0.615), and 0.520 for total cholesterol (95% CI 0.482 to 0.537). In conclusion, these findings indicate that the ratio of oxidized LDL to HDL cholesterol was a more potent biomarker for discriminating between subjects with and without coronary artery disease than traditionally measured lipids and lipoproteins and Lp-PLA2. (C) 2006 Elsevier Inc. All rights reserved.