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Lipids Health Dis. 2019 Nov 19;18(1):202. doi: 10.1186/s12944-019-1144-y.

Comparison of Apolipoprotein B/A1 ratio, Framingham risk score and TC/HDL-c for predicting clinical outcomes in patients undergoing percutaneous coronary intervention.

Tian M1,2, Li R1,2, Shan Z3, Wang DW1,2, Jiang J4,5, Cui G6,7,8.

Author information

1
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
2
Hubei Province Key Laboratory of Genetics and Molecular, Mechanisms of Cardiological Disorders, Wuhan, 430030, China.
3
Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan, School of Public Health, Boston, MA, USA.
4
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. jiangjg618@126.com.
5
Hubei Province Key Laboratory of Genetics and Molecular, Mechanisms of Cardiological Disorders, Wuhan, 430030, China. jiangjg618@126.com.
6
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. cuiguanglin@tjh.tjmu.edu.cn.
7
Hubei Province Key Laboratory of Genetics and Molecular, Mechanisms of Cardiological Disorders, Wuhan, 430030, China. cuiguanglin@tjh.tjmu.edu.cn.
8
Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan, School of Public Health, Boston, MA, USA. cuiguanglin@tjh.tjmu.edu.cn.

Abstract

BACKGROUND:

Apolipoproteins (Apo) are known atherogenic factors that play important roles in many mechanisms related to coronary heart disease (CHD). However, it is unclear whether the apoB/apoA1 ratio is an equal or a better predictor than the Framingham Risk Score or TC/HDL-c for predicting clinical outcomes in patients undergoing percutaneous coronary intervention.

METHODS:

We investigated the association between Apolipoprotein B/A1 ratio and cardiovascular risk factors as well as the severity of CHD in 2256 Han Chinese patients. The potential of Apolipoprotein B/A1 ratio, Framingham Risk Score and TC/HDL-c were assessed as a marker to predict cardiovascular adverse events in a prospective subgroup of 1639 CHD patients during a 5-year follow-up.

RESULTS:

In the multivariate model, adjusted odds ratios (ORs) were significant for 3-VD vs. 1-VD (OR = 2.36; 95% CI: 1.65-3.38, for the fourth vs. first quartile; Ptrend < 0.001). The subgroup analysis showed that patients with a higher ApoB/ApoA1 ratio had an increased risk of developing multi-branch lesions and potentially suffer more cardiovascular adverse events (anginas, myocardial infarctions, heart failures, strokes, and cardiac deaths) in the future (adjusted HR =1.92; 95% CI: 1.10-3.13, for the fourth vs. first quartile). In the ROC analysis, the AUC for ApoB/A1 ratio was larger than that of Framingham Risk Score (0.604 vs. 0.543, p = 0.01) and TC/HDL-c (0.604 vs. 0.525, p < 0.01).

CONCLUSION:

Our results suggest a significant association between ApoB/ApoA1 ratio and CHD severity and cardiovascular outcomes among patients with existing CHD and ApoB/A1 ratio demonstrated a better predictive accuracy for clinical outcomes compared with Framingham Risk Score and TC/HDL-c.

KEYWORDS:

Apolipoprotein B/A1 ratio; Coronary heart disease; Percutaneous coronary intervention

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