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Erschienen in:
01.03.2015 | Original article
Apolipoprotein B/apolipoprotein A1 ratio and non-high-density lipoprotein cholesterol
Predictive value for CHD severity and prognostic utility in CHD patients
Erschienen in: Herz | Sonderheft 1/2015
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Background and aims
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.
Conclusion
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.