Apolipoproteins A-I and B-markers in coronary risk evaluation.
OBJECTIVE
To investigate if apoB, apoA-I and apoB/apoA-I ratios are independent risk factors for coronary heart disease and to determine their value in relationship with serum lipid fractions in evaluating the risk of coronary events.


METHODS
We carried out a comparative observational study on 289 subjects divided into two groups: 144 subjects with old myocardial infarction, and 145 subjects without coronary heart disease, but with cardiovascular risk factors. None of the subjects received lipid-lowering drugs in the previous 3 months.


RESULTS
The mean values of lipid fractions were lower in subjects with myocardial infarction than in subjects without coronary heart disease: total cholesterol (186.06 +/- 48.11 vs. 206.93 +/- 42.28 mg/dl, p = 0.0001), LDL-cholesterol (118.57 +/- 42.95 vs. 129.53 +/- 39.75 mg/dl, p = 0.023), HDL-cholesterol (43.64 +/- 12.32 vs. 50.48 +/- 21.09 mg/dl, p = 0.0008) and triglycerides (145.38 +/- 62.74 vs. 167.56 +/- 82.11 mg/dl, p = 0.01). The plasmatic levels of apoB were higher in subjects with myocardial infarction (1.12 +/- 0.57 vs. 0.86 +/- 0.27 g/l, p = 0.0001), but the apoA-I was lower (1.31 +/- 0.47 vs. 1.40 +/- 0.39 g/l, p = 0.101). The multivariate analysis indicated that plasmatic concentrations of apoB over 1.7 g/l are closely correlated with myocardial infarction (OR 3.96; 95% CI 2.87-5.02, p = 0.001) independent of other covariables such as age, smoking, diabetes, hypertension, lipid CT/HDL-C and the LDL-C/HDL-C ratio. The protective effect of apolipoprotein A1 against cardiovascular events after the adjustment for other cardiovascular risk factors (OR 0.72; 95% CI 0.57-0.83, p = 0.004) was also independent in multivariate analysis.


CONCLUSIONS
These results highlight the significance of apoA-I and apoB in the evaluation of the cardiovascular risk. From this point of view, their predictive value is superior to that of serum lipid fractions. The data suggest that the determination of apoA-I and apoB is useful enough to be introduced in current clinical practice.
Agoston-Coldea
Lucica
L
Department of Internal Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. lucicoldea@yahoo.fr
Zdrenghea
D
D
Pop
Dana
D
Crăciun
Alexandra
A
Rusu
M L
ML
Mocan
Teodora
T
D016632:Apolipoprotein A-I / Q000097:blood*; D001055:Apolipoproteins B / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors
D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL