Lipid and inflammatory markers for the prediction of coronary artery disease: A multi-marker approach.
Clinical biochemistry 2007 Jun 8; In press
Bogavac-Stanojević N N, Jelić-Ivanović Z Z, Spasojević-Kalimanovska V V, Spasić S S, Kalimanovska-Oštrić D D
Institute of Medical Biochemistry, Faculty of Pharmacy, POB 146, 11000 Belgrade, Serbia.
BACKGROUND:: Many studies have investigated the clinical accuracy of single lipid and inflammatory markers. In contrast, few have evaluated their potential for the detection of CAD using a multi-marker approach. METHODS:: The concentrations of lipid, lipoproteins, apolipoproteins, high sensitivity C-reactive protein (hs-CRP) and fibrinogen were measured by standard laboratory methods. Apolipoprotein (a) [apo(a)] phenotyping was performed by sodium dodecylsulphate-gel electrophoresis and immunoblotting. The lipid tetrad index (LTI) and the lipid pentad index (LPI) were calculated. Clinical accuracy of the examined parameters, indexes and a logistic regression model was assessed using receiving operative characteristic (ROC) curve analysis. RESULTS:: Logistic regression analysis indicated that non-HDL-c, hs-CRP, HDL-c and Lp(a) were significant independent predictors for CAD. The AUC for this model (0.802) was higher than AUCs for any single marker or index tested. CONCLUSIONS:: We conclude that the performance of a logistic regression model for CAD prediction warrants its use in clinical practice.