Yonsei Med J.  2006 Jun;47(3):405-414. 10.3349/ymj.2006.47.3.405.

Significance of Small Dense Low-Density Lipoprotein as a Risk Factor for Coronary Artery Disease and Acute Coronary Syndrome

• Kwon SW
• Yoon SJ
• Kang TS
• Kwon HM
• Kim JH
• Rhee J
• Lee SJ
• Park JK
• Lim JY
• Yoon YW
• Hong BK

• KMID: 1715861
• DOI: http://doi.org/10.3349/ymj.2006.47.3.405

Abstract

Small dense LDL (sd-LDL) has recently emerged as an important coronary artery disease (CAD) risk factor. This study was performed to investigate how LDL particle size is related to CAD and acute coronary syndrome (ACS). Blood samples were collected from 504 patients that underwent coronary angiography to evaluate chest pain. The LDL particle size of these samples was measured. The mean LDL particle size was smaller in patients with angiographically proven CAD than in the controls (26.41+/-0.95 vs 26.73+/-0.64nm, p < 0.001), and was negatively correlated with the Framingham risk score (r=-0.121, p=0.007). Patients with more extensive CAD had smaller LDL particles. LDL particle size was also smaller in patients with acute coronary syndrome as compared to non-ACS patients (26.09+/-1.42 vs 26.54+/-0.63nm, p=0.011). These results suggest that sd-LDL is independently associated with the incidence and extent of CAD, and can be a risk factor for the development of ACS in the Korean population.

Keyword

Small dense LDL; coronary artery disease

MeSH Terms

Risk Factors
Predictive Value of Tests
Particle Size
Middle Aged
Male
Lipoproteins, LDL/*blood/chemistry
Humans
Female
Coronary Arteriosclerosis/*blood/*epidemiology
Biological Markers
Aged
Acute Disease

Figure

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  Fig. 1 (A) Comparison of pattern A and B mean Gensini scores. Mean Gensini scores for patterns A and B were significantly different (14.4 ± 22.9 vs 24.1 ± 28.9, p < 0.001). Pattern A represents a predominance of large, buoyant LDLs (mean particle size greater than 26.5 nm). Pattern B represents a predominance of small, dense LDLs (mean particle size smaller than 26.5 nm). (B) Correlation between mean LDL particle size and Gensini score. The mean LDL particle size had a significant negative correlation with the Gensini score (r = -0.188, p < 0.001). r, correlation coefficient.

• 

  Fig. 2 Correlation between mean LDL particle size and Framingham risk score. The mean LDL particle size had a negative correlation with GRAS (r = -0.121, p = 0.007). GRAS (global risk assessment score) was obtained by using the Framingham risk scoring method; LDL, low-density lipoprotein; r, correlation coefficient.

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