title: Erythrocyte-bound apolipoprotein B in atherosclerosis and mortality.
abstract: BACKGROUND
  The binding of apolipoprotein (apo) B-containing lipoproteins to circulating erythrocytes (ery-apoB) is associated with a decreased prevalence of atherosclerosis. In this study, we evaluated ery-apoB as a possible prognostic factor in cardiovascular events and all-cause mortality, in a prospective cohort study.
  
  
  METHODS
  Ery-apoB was measured by flow cytometry in subjects with and without cardiovascular disease (CVD). The primary endpoint was the cardiovascular event rate. Secondary endpoints were all-cause mortality and the combined endpoint of all-cause mortality and cardiovascular events (any event rate). A Cox regression analysis with univariate and multivariate analyses and Kaplan-Meier survival analysis was performed.
  
  
  RESULTS
  Follow-up data were available of 384 subjects. Subjects were divided according to high (> 2·0 au, n = 60), intermediate (0·2-2·0 au, n = 274) or low (< 0·2 au, n = 50) ery-apoB. Median follow-up was 1767 days (IQR 1564-2001). In univariate analysis, low ery-apoB was associated with increased all-cause mortality [HR 9·9 (1·2-79·0), P = 0·031] and any event rate [HR 3·4 (95% CI 1·3-8·7), P = 0·012]. In a Cox regression analysis, only a history of CVD was significantly associated with any event rate [HR 3·6 (1·6-8·0), P = 0·002], while low ery-apoB showed a trend [HR 2·4 (0·9-6·4), P = 0·07]. In a subgroup analysis, in subjects with a history of CVD, ery-apoB was significantly associated with all-cause mortality (log rank P = 0·021) and any event rate (log rank P = 0·009).
  
  
  CONCLUSIONS
  Low ery-apoB is associated with increased mortality and cardiovascular risk, especially in patients with a prior history of CVD. These subjects may benefit from more aggressive secondary prevention treatment.
authors.affiliation: Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Marijke A
authors.initials: MA
authors.lastname: de Vries
authors.affiliation: Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Selvetta S
authors.initials: SS
authors.lastname: van Santen
authors.affiliation: Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Boudewijn
authors.initials: B
authors.lastname: Klop
authors.affiliation: Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Noëlle
authors.initials: N
authors.lastname: van der Meulen
authors.affiliation: Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: van Vliet
authors.affiliation: Department of Clinical Chemistry, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Gert-Jan M
authors.initials: GM
authors.lastname: van de Geijn
authors.affiliation: Department of Clinical Chemistry, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: van der Zwan-van Beek
authors.affiliation: Department of Statistics and Education, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Erwin
authors.initials: E
authors.lastname: Birnie
authors.affiliation: Department of Cardiology, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Anho H
authors.initials: AH
authors.lastname: Liem
authors.affiliation: Department of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Wouter W
authors.initials: WW
authors.lastname: de Herder
authors.affiliation: Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Manuel
authors.initials: M
authors.lastname: Castro Cabezas
mesh_terms: D001055:Apolipoproteins B / Q000378:metabolism*; D050197:Atherosclerosis / Q000378:metabolism / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000378:metabolism / Q000401:mortality; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001055:Apolipoproteins B
keywords: Cardiovascular disease; complement receptor 1; immune adherence; inflammation; lipid; red blood cell