Evaluation of Homocysteine, Lipoprotein(a) and Endothelin as diagnostic markers of Coronary Artery Disease in Indian population

Abstract

Indians have been reported to have high prevalence rates of coronary artery disease (CAD) even in the absence of traditional risk factors. The objective of this study was to assess the role of endothelin, lipoprotein(a), homocysteine and lipid profile as markers of CAD in Indian population. It was a hospital based observational case-control study, which included 60 documented patients of CAD, and 50 age and sex matched controls. Routine biochemical parameters were performed. Lipoprotein(a), homocysteine and endothelin levels were estimated by enzyme linked immunosorbent assay. The levels of endothelin (9.78±0.40 pg/ml vs. 7.86±0.31 pg/ml), lipoprotein(a) (51.42±1.71 mg/dl vs. 36.26±1.21 mg/dl), homocysteine (21.31±1.22 μmol/L vs. 10.41±0.844 μmol/L) and LDL/HDL cholesterol ratio (4.23±0.32 vs. 2.60±0.10) were significantly higher whereas that of HDL (29.82±1.39 mg/dl vs. 40.82±6.24 mg/dl) was significantly lower in patients of CAD as compared to the controls (p<0.001). Area under receiver operating characteristic curve was >0.7 for all the markers. Higher levels of homocysteine, endothelin, and lipoprotein(a) were independently associated with increased risk of CAD. Thus, they may be helpful in risk assessment in premature cardiovascular disease and in individuals where traditional risk factors are not present.

Keywords: Atherosclerosis; CAD; Endothelin; Homocysteine; Lipoprotein(a)

Internet Journal of Medical Update. 2013 January;8(1):17-23