Preventing Premature Coronary Artery Disease: The Synergistic Role of Biomarker Screening and Physical Activity.

Abstract

Objective: With the increasing prevalence of premature coronary artery disease (CAD), early detection and risk stratification are crucial. While physical inactivity is linked to CAD risk, its impact in the early stages remains underexplored. This study aims to identify biomarkers for early CAD diagnosis and their association with physical activity (PA), ultimately reducing morbidity and mortality rates.

Methods: This case-control study enrolled 300 subjects aged 18-45 years. They were subdivided into three categories. Additionally, the 200 subjects in groups I and II were classified into active, moderate, and sedentary categories based on World Health Organization (WHO) criteria. Serum levels of high-sensitivity C-reactive protein (hs-CRP), lipoprotein (a) [Lp(a)], apolipoprotein A1 (Apo-A1), apolipoprotein B100 (Apo-B100), and oxidized low-density lipoprotein (oxidized LDL) were analyzed, whereas non-high-density lipoprotein cholesterol (non-HDL-C) was calculated. The comparison of these biochemical parameters was done in terms of mean ± standard error of the mean (SEM) and area under the receiver operating characteristic curve (AUROC), and their significance with PA was determined using one-way analysis of variance (ANOVA) and Bonferroni test.

Results: Significant differences in hs-CRP, Apo-B100, Lp(a), non-HDL-C, and oxidized LDL were observed across groups. AUROC analysis confirmed their strong association with CAD risk. Additionally, the findings highlight that an active lifestyle is linked to a more favorable biochemical profile, which may help mitigate the risk of premature CAD.

Conclusion: The study suggests including hs-CRP, Apo-B, Lp(a), non-HDL-C, and oxidized LDL in routine screening for early CAD detection. Despite their proven effectiveness, these biomarkers are not widely used. Therefore, integrating early biomarker screening with lifestyle modifications can enhance risk assessment and improve treatment outcomes.