Subclasses of LpA-I in coronary artery disease: distribution and cholesterol efflux ability.

We analysed the distribution of LpA-I particles according to their molecular weight in 34 men with symptomatic coronary artery disease (CAD) and 11 men with no symptoms of CAD (control group). Using an original rapid and reproducible gradient gel electrophoresis technique, three LpA-I subclasses were defined: large (L-LpA-I), intermediate (I-LpA-I) and small LpA-I (S-LpA-I). The proportion of L-LpA-I was significantly lower in the CAD group (37.5 +/- 18.5%) than in the control group (58.9 +/- 15.0%) (P < 0.01). Conversely, a significantly (P < 0.05) higher proportion of I-LpA-I (31.9 +/- 20.7%) was observed in the CAD group compared with the control group (14.2 +/- 8.2%). Also, in the CAD group, the proportion of L-LpA-I was positively associated with the plasma level of LpA-I (P < 0.05) and, conversely, the proportion of S-LpA-I was negatively associated with LpA-I levels (P < 0.01). L-LpA-I and I-LpA-I from CAD patients and from control subjects were most effective in promoting cholesterol efflux from Fu5AH rat hepatoma cells, whereas S-LpA-I was ineffective in this regard. In conclusion, the decreased ratio in CAD patients of L-LpA-I, lipoprotein subspecies that are required for cholesterol efflux from cells, suggests a potential anti-atherogenic effect of these particles associated with the larger LpA-I subfractions.