Apolipoprotein B/apolipoprotein A1 ratio and non-high-density lipoprotein cholesterol. Predictive value for CHD severity and prognostic utility in CHD patients.
OBJECTIVE
To explore the clinical value of the combination of apolipoprotein B/apolipoprotein A1 (apoB/A1) and non-high-density lipoprotein cholesterol (HDL-C) in evaluating the severity of coronary heart disease (CHD) and in predicting in-hospital CHD events and the long-term prognosis of CHD patients.


METHODS
According to the results of coronary angiography, 826 patients were enrolled and classified into a CHD group (532 cases, including single-branch stenosis group, n = 165; double-branch stenosis group, n = 175;and multi-branch stenosis group, n = 192) and a normal group (294 cases). The serum apoB/apoA1 ratio and non-HDL-C were calculated at baseline. The Gensini score and logistic regression were applied to analyze the association between the apoB/apoA1 ratio, non-HDL-C, and the severity of CHD. Major in-hospital adverse incidents were recorded and follow-up telephone interviews were conducted 3 years after discharge.


RESULTS
Both the apoB/apoA1 ratio and non-HDL-C rose with the number of stenotic coronary branches. Only apoB and apoB/apoA1 remained significantly associated with the risk of multi-branches lesions and the Gensini score after adjustment. Patients with combined high levels of apoB/apoA1 and non-HDL-C (N = 50, 43.10 %) suffered from the highest risk of multi-branches lesions. Similarly, patients with combined high levels of apoB/apoA1 and non-HDL-C not only suffered from the highest risk of in-hospital new-onset heart failure and cardiac death (16.38 % vs. 10.35 %), but also had the highest risk of adverse events, angina, myocardial infarction, new-onset heart failure, stroke, and cardiac death after an average 3-year follow-up.


CONCLUSIONS
The combination of apoB/apoA1 and non-HDL-C is predictive of the severity of CHD, and it could provide more prognostic information than its individual components or other routine lipid profiles.
Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197, Ruijin 2nd Road, Shanghai, China.
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P
Liting
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L
Guoping
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Zhenyue
D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D016632:Apolipoprotein A-I / Q000097:blood*; D053299:Apolipoprotein B-100 / Q000097:blood*; D015415:Biomarkers; D002681:China / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood*; D015897:Comorbidity; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D003643:Death; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D015996:Survival Rate
C569471:APOB protein, human; D016632:Apolipoprotein A-I; D053299:Apolipoprotein B-100; D015415:Biomarkers; D008078:Cholesterol, LDL