Lipid parameters in patients with acute coronary syndromes versus stable coronary artery disease

Background Differences in lipid parameters between patients with acute coronary syndromes ( ACS ) and patients with stable coronary artery disease ( CAD ) are unclear and are addressed in this study. Methods We enrolled 582 patients with angiographically proven stable CAD (of whom 26·9% had diabetes mellitus type 2 (T2 DM )) and 182 patients with ACS (of whom 35·8% had T2 DM ). Results HDL cholesterol and apolipoprotein A1 levels were significantly lower in patients with ACS than in patients with CAD (46 ± 16 mg/dL vs. 50 ± 16 mg/dL, P  < 0·001, and 139 ± 30 mg/dL vs. 155 ± 31 mg/dL, P  < 0·001, respectively). Analysis of covariance ( ancova ) adjusting for age, gender, smoking, BMI , statin therapy, alcohol use, hypertension and diabetic state confirmed an independent impact of ACS on HDL cholesterol and apolipoprotein A1 levels ( F  = 24·1; P  < 0·001). In contrast, total cholesterol, LDL cholesterol, non‐ HDL cholesterol and apolipoprotein B levels did not differ significantly between patients with ACS and patients with stable CAD . Conclusion HDL cholesterol and apolipoprotein A1 levels are lower in patients with ACS than in patients with stable CAD .