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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
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Association of an HDL Apolipoproteomic Score With Coronary Atherosclerosis and Cardiovascular Death

Pradeep Natarajan1, Tim S Collier2, Zhicheng Jin2

  • 1Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts.

Journal of the American College of Cardiology
|May 4, 2019
PubMed

Insights

A novel high-density lipoprotein (HDL) apolipoproteomic score (pCAD) effectively predicts coronary artery disease (CAD) presence and cardiovascular outcomes. This score offers valuable insights beyond traditional risk factors for CAD detection.

Area of Science:

  • Cardiovascular Medicine
  • Proteomics
  • Biomarker Discovery

Background:

  • Circulating apolipoprotein concentrations are established risk factors for coronary artery disease (CAD).
  • The incremental value of apolipoprotein levels within specific lipoprotein fractions for CAD risk prediction remains underexplored.

Purpose of the Study:

  • To assess the diagnostic and prognostic performance of an HDL apolipoproteomic score for detecting angiographic CAD and predicting cardiovascular outcomes.
  • To evaluate the score's independence from conventional cardiovascular risk factors.

Main Methods:

  • Targeted mass spectrometry was used to quantify HDL-associated apolipoproteins (apoA-1, apoC-1, apoC-2, apoC-3, apoC-4) in 943 participants undergoing coronary angiography.
  • A composite HDL apolipoproteomic score (pCAD) was developed and associated with obstructive CAD and 4-year cardiovascular outcomes.

Main Results:

  • The pCAD score was significantly associated with the presence of obstructive CAD (OR: 1.39; 95% CI: 1.14-1.69), independent of traditional risk factors including apoA-1 and apoB.
  • The C-index for pCAD in predicting obstructive CAD was 0.63.
  • While not associated with overall cardiovascular mortality, the pCAD score showed association with cardiovascular death in patients with obstructive CAD (HR: 1.48; 95% CI: 1.07-2.05).

Conclusions:

  • An HDL apolipoproteomic score (pCAD) demonstrates association with CAD presence, independent of established risk factors.
  • This score may offer independent prognostic value for cardiovascular mortality in individuals diagnosed with CAD.
Abstract

Keywords:
HDLcoronary artery diseaselipidspreventionproteomics

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