An observational study on the effect of ranolazine and trimetazidine in stable angina patients in a tertiary care hospital in eastern India

Coronary artery disease / Indian Heart Journal 69S (2017) S11-S36 Methods: We conducted a cross-sectional case control study at three centers in a South-Indian population.A total of 83 case-control pairs were enrolled under two groups; CAD patients with acute coronary syndrome (ACS) and age-gender matched healthy controls.Lp-PLA2 concentration and activity were measured using PLAC test and PLAC activity assay respectively (diaDexus Inc., San Francisco, CA, USA), while all other parameters were measured using standard commercially available kits.Results: A total of 83 subjects completed the study in the CAD group [mean age 51(±8.9)years, 85% males] and 83 subjects in the control group [mean age 50(±8.9)years, 86.5% males].Lp-PLA2 concentration positively correlated with TC ( = 0.19, p = 0.02), non-HDL-C ( = 0.20, p = 0.02), Lp-PLA2 activity ( = 0.27, p = 0.001) and Lp(a) (r = 0.25, p = 0.02).Lp-PLA2 activity correlated positively with TC ( = 0.28, p = 0.001), LDL-C ( = 0.30, p < 0.001), non-HDL-C ( = 0.35, p < 0.001), ApoB ( = 0.35, p < 0.001) and negatively correlated to HDL-C ( = -0.24,p = 0.004).Cox proportionality hazards model revealed Lp-PLA2 concentration (ˇ= 0.006, SE = 0.002, p = 0.009) to have positive association with the event of CAD and negative association for ApoA1 (ˇ= -0.06, SE = 0.02, p = 0.001).Receiver Operating Characteristic (ROC) analysis revealed that the highest quartile of Lp-PLA2 concentration to have Area Under Curve (AUC) of 0.80 (95% CI, 0.65-0.9,p < 0.001) with cut off value of >427 ng/mL.Conclusions: In this study population, circulating plasma Lp-PLA2 was found to be elevated in CAD group.ApoA1 showed negative association and Lp-PLA2 concentration showed positive association with risk for CAD.In the highest quartile, Lp-PLA2 concentration had the best diagnostic utility.Our results support the hypothesis that Lp-PLA2 may be a potential risk marker for CAD in Indians.