Evaluation of Non-HDL-Cholesterol/HDL-cholesterol ratio as a predictor of coronary artery disease

Background and Objectives: Higher prevalence of coronary artery disease (CAD) has been reported in Indian population, which cannot be accounted for by the traditional risk factors. Identification of new risk factors which would help in treatment and prevention of CAD is of utmost importance in India. Many cardiovascular risk predictors which also include some lipid ratios are already in use. Recently apoB/apoA-1 ratio has been found to be good predictor for assessing cardiovascular risk. Our aim of this study was to find the relevance of non-HDL-C/HDL-C ratio, in comparison to apoB/apoA-1 ratio which has already been established as a predictor of coronary artery disease. Methods: 110 patients of CAD (coronary artery disease) of mean age (41.01+ 9.20) and 50 healthy controls (mean age-33.14+10.32) were enrolled for the study. Extended lipid profile with serum apolipoprotein A-1 and B was undertaken for each subject. Non-HDL-C was calculated (Total cholesterol-HDL cholesterol). Ratios of apoB/apoA-1 and non-HDL/HDL were calculated and statistically evaluated. Statistical Analysis: Unpaired t test was used to compare the means. A p value<0.05 was considered significant. Area under the receiver operating characteristic curve was calculated to assess the utility and to compare the predictive value of the ratios of apoB/apoA-1 and non-HDL-C/HDL-C. Results: Both the ratios were significantly higher in cases compared to the controls (P<0.001). The greater AUC of the ROC curve was obtained with the non-HDL/HDL ratio. Conclusion: Based on our findings we recommend the use of non-HDL/HDL ratio in Indian population for assessing risk of coronary artery disease.