Comparison of Apolipoprotein Concentrations and Values of APOB:APOAI with Traditional Lipid Measures in Women Diagnosed with Acute Cornonary Syndromes - A Preliminary Report.
BACKGROUND
Acute coronary syndromes (ACS) are the leading cause of hospitalization and death in the modern world. Reliable indicators of risk assessment could be useful in clinical investigation. Results from recent studies suggest that apolipoprotein measurement and apoB:apoI ratio are superior to traditional lipids in the estimation of coronary risk. We compared apolipoprotein concentrations and apoB:apoAI index with traditional lipid measures in ACS patients.


METHODS
A study group consisted of 94 women diagnosed with ACS (STEMI=21, NSTEMI=25 and UA=48). Clinically healthy volunteers (n=30) served as controls. Measurements of serum cardiac TnI, lipid profile, high sensitivity C-reactive protein, apolipoprotein AI and apoB100 concentrations were performed and apoB:apoAI ratio was calculated.


RESULTS
ACS patients had significantly decreased median HDL-cholesterol, increased atherogenic indexes TC:HDL-C, apoB:apoAI and abnormally high CRP compared to controls. Median LDL-cholesterol and apoAI concentrations, although significantly higher in ACS patients, remained within the normal range. Comparison of atherogenic indexes in ACS patients has shown increased TC:HDL-C (>4) and apoB:apoAI (>0,3) in 60,4% and 96,8% of which 55,4% had moderate and high risk (>0,6). ApoB:apoAI ratio was of good diagnostic utility for discrimination between ACS cases and non-ACS controls (AUC=0,715), and little better than TC:HDL-C. In both groups similar percentage of increased LDL-C and triglycerides was observed whereas increased apoB concentration was three times more likely in ACS cases. The highest apoB:apoAI was observed predominantly in STEMI cases (49%) whereas the lowest in UA and NSTEMI (30%).


CONCLUSIONS
Determination of apolipoproteins and assessment of apoB:apoAI ratio seems to be useful and better tool than traditional lipid measures in assessing risk of acute coronary syndromes in women.
Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University , Bydgoszcz, Poland.
Magdalena
M
Krintus
Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University , Bydgoszcz, Poland.
Katarzyna
K
Bergmann
Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University , Bydgoszcz, Poland.
Grazyna
G
Sypniewska
Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University , Bydgoszcz, Poland.
Marcin
M
Sawicki
J Intern Med. 2004 Feb;255(2):188-205
14746556
Kardiol Pol. 2005 May;62 Suppl 1:I5-7
19810334
Clin Chem. 1998 Jan;44(1):134-40
9550570
J Intern Med. 2006 May;259(5):493-519
16629855
Atheroscler Suppl. 2006 Aug;7(4):23-7
16822722
Atherosclerosis. 2009 Jul;205(1):284-9
19124125
Eur Heart J. 2009 Sep;30(17):2137-46
19520708
QJM. 2006 May;99(5):277-87
16504986
Clin Geriatr Med. 2007 May;23(2):307-25, vi
17462519