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Cardiovascular Research 1998 37(3):729-737; doi:10.1016/S0008-6363(97)00286-1
© 1998 by European Society of Cardiology
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Copyright © 1998, European Society of Cardiology

High-density lipoprotein particles are large in patients with variant angina

Kunihisa Miwa*, Naohiro Yoshida, Keiko Nakagawa and Hiroshi Inoue

The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-01, Japan

* Corresponding author. Tel.: +81 (764) 342281, ext. 2507; Fax: +81 (764) 345026.

Objective: Dyslipidemia in patients with coronary vasospasm may be characterized by low level of high-density lipoprotein (HDL)-cholesterol as well as apolipoprotein (apo) A-I but not high level of low-density lipoprotein-cholesterol. This study sought to examine the HDL particle size in patients with variant angina. Methods: The HDL particle size was examined by analyzing serum lipid levels in 38 patients with variant angina to compare with those of 40 control subjects and 30 normocholesterolemic patients with stable effort angina. Also, actual HDL size distribution was assessed by electrophoresis. Results: The HDL-cholesterol, apoA-I and apoA-II levels were all lower (P<0.01 for each) in patients with variant angina and patients with stable effort angina as compared with control subjects. The apoA-II level was lower (P<0.01) in patients with variant angina than in patients with stable effort angina. The apoA-I/apoA-II ratio was lower (P<0.01) in patients with stable effort angina, but not in patients with variant angina as compared with control subjects. In contrast, the HDL-cholesterol/apoA-I ratio was higher in patients with variant angina than in control subjects (P<0.01) and also patients with stable effort angina (P<0.01). The slope of the regression line, comparing HDL-cholesterol and apoA-I levels, was greater in patients with variant angina than in control subjects (P<0.05) and patients with stable effort angina (P<0.05), suggesting an increase in larger HDL particles. Native polyacrylamide gel electrophoresis revealed that HDL particles in patients with variant angina were skewed towards larger sizes compared with control subjects (P<0.01) and patients with stable effort angina (P<0.01). The abnormal serum lipid values were normalized in the patients with variant angina after the medical treatment and inactivation of the coronary spasm. Conclusion: High HDL-cholesterol/apoA-I levels associated with low serum HDL-cholesterol and apoA-I levels were characteristic in patients with variant angina, in whom HDL particles were large, cholesterol-rich and possibly malfunctioning.

KEYWORDS Variant angina; Coronary spasm; High density lipoprotein; High density lipoprotein cholesterol; Apolipoprotein A-I


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 J Am Coll CardiolHome page
K. Miwa, K. Nakagawa, N. Yoshida, Y. Taguchi, and H. Inoue
Lipoprotein(a) is a risk factor for occurrence of acute myocardial infarction in patients with coronary vasospasm
J. Am. Coll. Cardiol., April 1, 2000; 35(5): 1200 - 1205.
[Abstract] [Full Text] [PDF]


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