Cardiovascular status of carriers of the apolipoprotein A-IMilano mutant: The limone sul garda study

Cesare R. Sirtori, Laura Calabresi, Guido Franceschini, Damiano Baldassarre, Mauro Amato, Jan Johansson, Massimo Salvetti, Cristina Monteduro, Roberto Zulli, Maria L. Muiesan, Enrico Agabiti-Rosei

Research output: Contribution to journalArticlepeer-review


Background - Carriers of the apolipoprotein A-IMilano (apoA-IM) mutant present with very low plasma HDL cholesterol and moderate hypertriglyceridemia, apparently not leading to premature coronary heart disease. The objective of this study was to establish whether this high-risk lipid/lipoprotein profile is associated with structural changes in the carotid arteries and heart, indicative of preclinical atherosclerosis. Methods and Results - Twenty-one A-IM carriers were compared with age- and sex-matched control subjects from the same kindred and with 2 series of matched subjects with primary hypoalphalipoproteinemia (HA). Structural changes in the carotid arteries were defined as the intima-media thickness (IMT) measured by B-mode ultrasound. HA subjects, both recruited among patients attending our Lipid Clinic and blood donors, showed significant thickening of the carotids (average IMT, 0.86±0.25 and 0.88±0.29 mm, respectively) compared with control subjects (average IMT, 0.64±0.12 mm); the apoA-IM carriers instead showed normal arterial thickness (average IMT, 0.63±0.10 mm). Moreover, a significantly higher prevalence of atherosclerotic plaques was found in patients and blood donors with HA (both 57%) compared with apoA-IM carriers (33%) and control subjects (21%). Echocardiographic findings and maximal treadmill ECG did not differ significantly between apoA-IM carriers and control subjects, apart from a slight increase in left ventricular end-diastolic dimension in the carriers. Conclusions - Despite severe HA, carders of the apoA-IM mutant do not show structural changes in the arteries and heart, in contrast to HA subjects, who are characterized by a marked increase in carotid IMT and increased prevalence of atherosclerotic plaques.

Original languageEnglish
Pages (from-to)1949-1954
Number of pages6
Issue number15
Publication statusPublished - Apr 17 2001


  • Apolipoproteins
  • Carotid arteries
  • Heart diseases
  • Intima-media thickening
  • Lipoproteins

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine


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