Non-high density lipoprotein cholesterol-risk predictor for coronary heart disease in Indian population

Background: Although low-density lipoprotein cholesterol (LDL-C) is a well established atherogenic factor for coronary heart disease (CHD), it does not completely represent the risk associated with atherogenic lipoproteins in the presence of high triglyceride levels. Non high density lipoprotein cholesterol (non-HDL-C) is considered to be a measure of apolipoprotein B containing atherogenic lipoprotein and a better predictor for cardiovascular risk. The aim of this study was to evaluate the role of non-HDL-C as an atherosclerotic predictor and its association with the severity of coronary heart disease. Methods: The study consisted of 185(males/females)(aged 20-60 years, mean age 42.24+10.94) patients of CHD and 50 healthy controls. Out of 185 patients 75 were angiographically proven while the remaining 110 cases were diagnosed on the basis of clinical and echocardiographic findings. Based on the results of coronary angiography the 75 patients were further divided into three sub group according to severity of coronary artery disease (single, double and triple vessel disease). Fasting blood samples were assessed for Total cholesterol, HDL-cholesterol and Triglycerides. LDL-C was estimated by direct method and non-HDL-C was calculated. The levels of non-HDL-C in different grades of coronary vessel diseases were correlated and compared. Results: The non-HDL-C level in CHD group was significantly higher than in the control group (p<0.001). Further the levels of non-HDL cholesterol were lower in single (157.14+13.70 vs 179.23+22.52, 210.05+28.85 mg/dl; [p<0.001]) vs double and triple vessel respectively) and thus, directly correlating with severity of CHD. Conclusion: Serum non-HDL-C is closely associated with the development and severity of CHD.