Prognostic value of lipoproteins and their relation to inflammatory markers among patients with coronary artery disease.
BACKGROUND
Lipoproteins and their subfractions are associated with the incidence of atherosclerotic diseases. In patients with coronary artery disease (CAD), low serum concentrations of high density lipoprotein (HDL) and high low-density lipoproteins (LDL) are correlated to myocardial infarction and cardiovascular death. There is growing evidence indicating that those lipoprotein factors are related to the inflammatory process in atherogenesis.


METHODS
We investigated in a median follow up of 3.9 years the association of HDL, apolipoprotein A-I (apoA-I), LDL, apolipoprotein B (apoB), and triglycerides with the incidence of a combined endpoint (myocardial infarction and cardiovascular death) and their relation to markers of inflammation in 1298 patients with angiographically documented CAD.


RESULTS
In univariate analysis, serum concentrations of apoA-I were significantly and inversely related to the combined endpoint, whereas serum concentrations of LDL, apoB, and triglycerides were not. HDL was not significantly related to the endpoint in univariate analyses (p=0.057). Multivariate analyses showed that only apoA-I is an independent predictor. ApoA-I (and HDL) was significantly related to markers of inflammation.


CONCLUSIONS
Serum apoA-I levels were an independent predictor for fatal and non-fatal cardiovascular events in patients with CAD. This may be related to its anti-inflammatory effect.
Schlitt
Axel
A
Department of Medicine II, Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, 55101 Mainz, Germany. axelschlitt@gmx.net
Blankenberg
Stefan
S
Bickel
Christoph
C
Meyer
Juergen
J
Hafner
Gerd
G
Jiang
Xian-Cheng
XC
Rupprecht
Hans J
HJ
D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000503:physiopathology; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
D016632:Apolipoprotein A-I; D015415:Biomarkers; D008074:Lipoproteins