APOLIPOPROTEIN B / A1 RATIO AS RISK PREDICTOR OF ANGIOGRAPHICALLY PROVEN ATHEROSCLEROSIS (original) (raw)
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The apolipoprotein b/apolipoprotein a-I ratio as a potential marker of plasma atherogenicity
Disease markers, 2015
Background. The apolipoprotein (apo) B/apoA-I ratio represents the balance between apoB-rich atherogenic particles and apoA-I-rich antiatherogenic particles, and this ratio is considered to be a marker of cardiovascular risk. Although many studies have demonstrated the importance of the apoB/apoA-I ratio in predicting the presence or absence of cardiovascular disease, less is known about apoB/apoA-I ratio as a marker of plasma atherogenicity. Methods. A total of 157 normolipidemic men aged 20-59 years were included in the study. The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apoA-I, apoB, and apoE were determined after a 12 h fasting period. Results. The median of the apoB/apoA-I ratio in the studied normolipidemic subjects was 0.52, with values ranging from 0.19 to 2.60. The percentage of subjects with the apoB/apoA-I ratio exceeding 0.9 (the accepted risk value of cardiovascular disease) was 19.1%. The subjects with a...
La Ricerca in Clinica e in Laboratorio, 1988
Since AVOGARO et al. 5 suggested that apolipoproteins are more useful than plasma and high-density lipoprotein (HDL)-cholesterol in discriminating between patients with coronary artery disease (CAD) and normal subjects, many studies have been performed to address the question of whether apolipoproteins may be better discriminators than plasma lipids for the risk of CAD ~.s, 4. 7.s,~.~5. Also KOTTKE et al. 14 have confirmed and extended the finding that plasma apolipoproteins A-I, A-II and B are better disease discriminators than plasma and HDL-cholesterol (sensitivity of detecting clinically significant coronary artery disease was estimated to be 76%). REARDON et al. ~4 suggested that in men the score for severity of atherosclerosis is strongly related to lowdensity lipoprotein (LDL)-cholesterol and apo B concentrations, whereas in women it is related to the triglyceride concentrations in intermediate-density lipoprotein (IDL) and LDL, as well as to the cholesterol and apo B concentrations in IDL. Moreover, no relationship was found between score for severity of atherosclerosis and HDL-cholesterol, or plasma apo A-I concentrations, in either studied group. Furthermore, ARo et al.~ and MILLER et al.Z~ suggested that determinations of apolipoproteins A-I, A-II and B do not correlate with angiographically proven CAD. Several factors might have contributed to this variability in previously published studies and among them: the selection of patients, the type of immunoassay used, and the statistical analysis applied.
The association between serum apolipoprotein A-I and apolipoprotein B, and the severity of
Introduction: The aim of this study was to investigate the relationship between serum apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) and the severity of coronary artery stenosis. Methods: This case-control study was carried out on 106 patients who underwent angiography and 100 healthy controls. ApoA-I and apoB as well as the serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglyceride and low-density lipoprotein cholesterol (LDL-C) levels were measured. Very low-density lipoprotein cholesterol levels and the LDL-C/HDL-C ratio were calculated. Results: In an Iranian population with coronary artery disease (79 men and 27 women, aged 53 +/− 8.5 years), the increased levels of apoA-I and apoB were correlated with the number of involved vessels and the severity of coronary lesions. However, no significant correlation was found between the serum values of lipids as well as other lipoproteins and the number of vessels involved and the severity of coronary lesions. Conclusion: ApoA-I and apoB are indicated as risk factors for cardiovascular and, possibly, cerebrovascular diseases. From this study, it may be concluded that apoA-I and apoB serum concentration levels are independent risk factors for coronary atherosclerosis in the Iranian population. It also demonstrates a direct relationship between the severity of coronary atherosclerosis and the number of lesions in the involved vessels. It can be regarded as an index for the relationship of apoA-I and apoB to the early, still clinically asymptomatic, steps of the pathogenesis of coronary disease.
Journal of Biosciences and Medicines, 2015
Atherosclerosis is the most important contributor to increasing burden of coronary artery disease (CAD). Growing evidence suggests that the ratios of Apo B/Apo A-I and Lp(a) are better indexes for risk assessment of CAD. Elevated plasma levels of lipoprotein(a) in humans represent a major inherited risk factor for atherosclerosis. Thus, a study was performed to determine the association betwwen serum Apo B, Apo A-I, and lipoprotein(a) levels, and severity of CAD in patients with CAD confirmed on coronary angiography findings. An analytical case control study was carried out with 85 patients (58 males and 27 females) 40 -60 years of age confirmed as having CAD on coronary angiography and 85 age and sex matched healthy volunteers as controls. Serum samples were analyzed for Apo A-1 LDL, Apo B, Apo A-I, and lipoprotein(a) concentration and the severity of CAD was assessed using coronary angiography scoring method. Patients with CAD had significantly high serum LDL-C, Apo B and Lp(a) levels compared to control subjects. However, serum Apo A-I level did not show a significant difference between two groups. Subjects with a positive family history of CAD with increased serum Lp(a) ≥ 17.3 mg/dL have high risk for development of CAD. Present study suggests that serum Lp(a) cut-off value of 17.3 mg/dL may be an important predictor in ruling out major vessel disease and luminal narrowing by atheroma.
Journal of Korean Medical Science, 2013
Despite the noninvasiveness and accuracy of multidetector computed tomography (MDCT), its use as a routine screening tool for occult coronary atherosclerosis is unclear. We investigated whether the ratio of apolipoprotein B (apoB) to apolipoprotein A1 (apoA1), an indicator of the balance between atherogenic and atheroprotective cholesterol transport could predict occult coronary atherosclerosis detected by MDCT. We collected the data of 1,401 subjects (877 men and 524 women) who participated in a routine health screening examination of Asan Medical Center. Significant coronary artery stenosis defined as > 50% stenosis was detected in 114 subjects (8.1%). An increase in apoB/A1 quartiles was associated with increased percentages of subjects with significant coronary stenosis and noncalcified plaques (NCAP). After adjustment for confounding variables, each 0.1 increase in serum apoB/A1 was significantly associated with increased odds ratios (ORs) for coronary stenosis and NCAP of 1.23 and 1.18, respectively. The optimal apoB/A1 ratio cut off value for MDCT detection of significant coronary stenosis was 0.58, which had a sensitivity of 70.2% and a specificity of 48.2% (area under the curve, 0.61; 95% CI, 0.58-0.63, P < 0.001). Our results indicate that apoB/A1 ratio is a good indicator of occult coronary atherosclerosis detected by coronary MDCT.
Clinical Chemistry and Laboratory Medicine (CCLM), 2006
Background: The ratio of low-to high-density lipoprotein-cholesterol (LDL-C/HDL-C) conventionally represents the balance of proatherogenic and antiatherogenic lipids. However, growing evidence supports the idea that the ratio of apolipoprotein (apo) B/ apoAI is a better index for risk assessment of coronary artery disease (CAD). The aim of this study was to evaluate the efficiency of advanced profile of serum (apo)lipoproteins for predicting stable CAD in secondary prevention. Methods: The study subjects, 138 men and 126 women aged 40-70 years, were classified as CAD cases or controls, according to the results of coronary angiography. The severity of CAD was scored on the basis of the number and extent of lesions in coronary arteries. Serum (apo)lipoproteins were measured by immunoturbidometric and electrophoresis methods. Results: Patients with CAD compared with controls had increased serum levels of triglycerides (2.6"2.0 vs. 2.0"1.2 mmol/L, pF0.005), apoB (1.36"0.31 vs. 1.19"0.24 g/L, pF0.0001), lipoprotein(a) wLp(a)x (0.69"0.60 vs. 0.43"0.31 g/L, pF0.0001) and apoB/ apoAI ratio (1.07"0.32 vs. 0.87"0.18, pF0.0001), and decreased serum levels of HDL-C (1.02"0.29 vs. 1.11"0.34 mmol/L, pF0.03), apoAI (1.32"0.22 vs. 1.37"0.19 g/L, pF0.04) and LDL-C/apoB ratio (0.91"0.32 vs. 1.02"0.25 mmol/g, pF0.01). Multiple logistic regression analysis after adjusting for major risk factors showed that the apoB/apoAI ratio, apoB and Lp(a) were among seven significant and independent determinants of CAD. The area under the receiver operating characteristic (ROC) curves (AUC) as a relative measure of test efficiency was highest and significant for the apoB/apoAI ratio (AUCs0.71, pF0.0001), apoB (0.67, pF0.0001), Lp(a) (0.63, pF0.001), the LDL-C/apoB ratio (0.62, pF0.006), triglycerides (0.62, pF0.004) and apoAI (0.58, pF0.05). ANOVA analysis showed significant association for the apoB/apoAI ratio, apoB, Lp(a) and triglycerides, and moderate association for total cholesterol and its subfractions, with the severity of CAD. Conclusions: The results indicate that the apoB/apoAI ratio, apoB and Lp(a) are independent risk factors for
European Heart Journal, 2008
Prospective studies indicate that apolipoprotein measurements predict coronary heart disease (CHD) risk; however, evidence is conflicting, especially in the US. Our aim was to assess whether measurements of apolipoprotein B (apoB) and apolipoprotein A-I (apoA-I) can improve the ability to predict CHD death beyond what is possible based on traditional cardiovascular (CV) risk factors and clinical routine lipid measurements. Methods and results We analysed prospectively associations of apolipoprotein measurements, traditional CV risk factors, and clinical routine lipid measurements with CHD mortality in a multi-ethnic representative subset of 7594 US adults (mean age 45 years; 3881 men and 3713 women, median follow-up 124 person-months) from the Third National Health and Nutrition Examination Survey mortality study. Multiple Cox-proportional hazards regression was applied. There were 673 CV deaths of which 432 were from CHD. Concentrations of apoB [hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.09-3.61], apoA-I (HR 0.48, 95% CI 0.27-0.85) and total cholesterol (TC) (HR 1.17, 95% CI 1.02-1.34) were significantly related to CHD death, whereas high density lipoprotein cholesterol (HDL-C) (HR 0.68, 95% CI 0.45-1.05) was borderline significant. Both the apoB/apoA-I ratio (HR 2.14, 95% CI 1.11-4.10) and the TC/HDL-C ratio (HR 1.10, 95% CI 1.04-1.16) were related to CHD death. Only apoB (HR 2.01, 95% CI 1.05-3.86) and the apoB/apoA-I ratio (HR 2.09, 95% CI 1.04-4.19) remained significantly associated with CHD death after adjusting for CV risk factors. Conclusion In the US population, apolipoprotein measurements significantly predict CHD death, independently of conventional lipids and other CV risk factors (smoking, dyslipidaemia, hypertension, obesity, diabetes and C-reactive protein). Furthermore, the predictive ability of apoB alone to detect CHD death was better than any of the routine clinical lipid measurements. Inclusion of apolipoprotein measurements in future clinical guidelines should not be discarded.
Arquivos brasileiros de …, 1999
Objective-To evaluate whether apolipoproteins A-I (Apo A-I) and B (Apo B) have, higher ensitivity (SN), specificity (SP) and positive predictive value (PPV) than lipoproteins (LP), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triglycerides (TGL) in assessing the risk of coronary heart disease (CHD). Methods-This is a transversal case-control study of 241 patients, who were divided into two groups: 1) 145 patients with CHD, and 2) 96 patients without coronary disease. A model of logistic regression to evaluate the relation between the LPs and CHD was developed in which variables with a p-alpha <0.1 were included.
Indian journal of clinical biochemistry : IJCB, 2004
Serum total lipids (cholesterol and triglyceride), lipoproteins (VLDL, LDL and HDL) and Apolipoprotein-B levels of normal healthy individuals (n=25) and coronary artery disease patients (n=25) were estimated. The objective of the present study was to ascertain the role of apo-B in causation and inheritance of coronary artery disease. It was observed that on an average serum total cholesterol and triglyceride more than 200 mg/dl bring the individuals to a risk of coronary artery disease (CAD) irrespective of the age. CAD patients achieved this value at an early age (35-45 years). Similarly VLDL and LDL levels were found to be significantly raised in CAD patients when compared to that of age matched normal individuals, with patients achieving risk values at an early age. HDL levels were found to be significantly lower in CAD patients as compared to normal individuals. Serum apo-B levels were significantly raised in CAD patients as compared to age matched normal individuals. Patients w...