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1 Heart Project
Cardiovascular diseases (CVDs), a group of disorders involving heart and blood vessels, are the leading cause of premature global mortalities, accounting for ~18 million annual global deaths [1]. Consequently CVDs, particularly coronary heart diseases (CHDs) or coronary artery disease (CAD), have spread in India like an epidemic; primarily caused by the combinations of early age of onset, rapid progression and high mortality rates [2]. Some important CHD risk factors include dyslipidemia, diabetes, hypertension, (abdominal) obesity, unhealthy diet, psychosocial stress, smoking and physical inactivity. Apparently healthy Indians aged 40 years have 50% chances of developing atherosclerosis leading to CHDs, with the risk increasing with age. Therefore, suitable preventive strategies like early and accurate prediction of CHDs and proper treatments to halt the disease are required to combat this epidemic.
Though cholesterol (LDL-C) is an established indicator of CHD risks; apolipoproteins -b (Apo B) and -a1 (Apo A1) are emerging as critical risk factors [3]. Plasma concentration of Lp(a) (lipoprotein a), a genetic factor, is also an important risk factor, more atherogenic than LDL-C [4]. Thus, we believe that the concentrations of lipo & apolipo -proteins and their ratios in plasma probably can simplify, unify and amplify the atherogenic potential of CHD biomarkers. So, for routine monitoring of CHD status, Doyen Diagnostic & Research Foundation (DDRF) has developed a unique proprietary lipid profile test, called Lipoprofile EXT, a registered trademarked service product from Govt. of India. Moreover, we also have an advance lipid profile test available for diagnostic evaluation of CHDs, called LipoProfile EXT+, which includes genetic marker like Lp(a), and non-conventional but more accurate newer predictive markers like Apo- A, B along with other conventional lipid parameters.
In our current CAD research we are using machine learning and algorithmic approach to improve the predictive efficacy of CHD risk factors. Using archived old repository we are analyzing retrospective lipo-profile data to establish biological reference ranges of lipid parameters in males and females from multiple age groups of eastern Indian population. We aim to find any potential correlation between plasma LDL and Lp(a) levels, which will be a novel and highly significant piece of diagnostic information. Subsequently, in the prospective part of our study, based on those reference ranges and ratios, we will apply our algorithm evaluating plasma levels of various markers like lipoprotein A, apo-lipoproteins, LDL and their ratios as better predictive CHD biomarkers.
References:
1. https://www.who.int/india/health-topics/cardiovascular-diseases
2. Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India. Circulation. 2016;133:1605e1620
3. McQueen MJ et al. (2008). Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infection in 52 countries (the INTERHEART study): a case-control study. Lancet 372, 224–233.
4. Loscalzo J. Lipoprotein (a). A unique risk factor for atherothrombotic disease. Arteriosclerosis: An Official Journal of the American Heart Association, Inc.. 1990; 10(5):672-9.
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