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Assessment of apolipoprotein B/apolipoprotein A-I ratio in non-ST segment elevation acute coronary syndrome patients
Haitham Galal1, Ayman Samir2, Mohamed Shehata2
1Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. haitham-w@hotmail.com.
Insights
The apolipoprotein B/apolipoprotein A-I ratio effectively assesses risk in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients. Higher ratios indicate more severe coronary artery disease and complex lesions, aiding in risk stratification.
Area of Science:
- Cardiovascular Medicine
- Clinical Chemistry
- Biomarker Discovery
Background:
- The apolipoprotein B/apolipoprotein A-I ratio is a known risk factor for myocardial infarction.
- Non-ST segment elevation acute coronary syndrome (NSTE-ACS) requires accurate diagnostic and prognostic tools.
- Previous studies highlight the association between this ratio and cardiovascular risk.
Purpose of the Study:
- To investigate the diagnostic value of the apolipoprotein B/apolipoprotein A-I ratio in NSTE-ACS patients.
- To explore the short-term prognostic significance of this ratio in NSTE-ACS.
- To compare lipid profiles and apolipoprotein levels between NSTE-ACS and stable angina patients.
Main Methods:
- Prospective enrollment of 100 NSTE-ACS patients and 100 matched stable angina controls.
- Quantification of serum lipids and apolipoproteins B and A-I.
- Coronary angiography performed in NSTE-ACS patients.
Main Results:
- NSTE-ACS patients exhibited significantly poorer lipid profiles, including higher apolipoprotein B/apolipoprotein A-I ratios.
- Elevated ratios correlated with increased coronary stenosis and more complex lesion morphology.
- Optimal cut-off values were identified for diagnosing NSTE-ACS (0.93) and predicting multi-vessel disease (0.82).
Conclusions:
- The apolipoprotein B/apolipoprotein A-I ratio is a valuable tool for risk assessment in NSTE-ACS.
- This ratio aids in predicting coronary multi-vessel involvement and lesion complexity.
- It serves as a useful biomarker for acute risk stratification in ischemic heart disease.
Background:
The apolipoprotein B/apolipoprotein A-I ratio was shown to be strongly related to the risk of myocardial infarction in several large-scale studies. The current study aimed at exploring the diagnostic and short-term prognostic values of apolipoprotein B/apolipoprotein A-I ratio in patients presenting with non-ST segment elevation acute coronary syndrome. One hundred patients with non-ST segment elevation acute coronary syndrome were prospectively enrolled, in addition to a matched group of 100 patients with chronic stable angina. Serum levels of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, and apolipoproteins B and A-I were quantified in both groups. Patients with non-ST segment elevation acute coronary syndrome underwent coronary angiography.
Results:
The mean age of the study population was 57 ± 6 years, 65% being males. The non-ST segment elevation acute coronary syndrome group showed significantly unfavorable lipid profile parameters, including apolipoprotein B/apolipoprotein A-I ratio. Higher apolipoprotein B/apolipoprotein A-I ratio was associated with more coronaries showing significant stenosis and more complex lesion morphology. Receiver operating characteristic curve analysis reached an optimal cut-off value of 0.93 for diagnosis of non-ST segment elevation acute coronary syndrome (sensitivity 70% and specificity 88%) and 0.82 for predicting the presence of multi-vessel disease (sensitivity 90% and specificity 97%).
Conclusion:
Apolipoprotein B/apolipoprotein A-I ratio is a useful tool of risk assessment in patients presenting with non-ST segment elevation acute coronary syndrome including prediction of coronary multivessel affection. Apolipoprotein B/apolipoprotein A-I ratio was shown to be strongly related to risk of myocardial infarction. Higher ratios of apolipoprotein B/apolipoprotein A-I were recorded in NSTE-ACS patients (versus stable angina patients). Higher apolipoprotein B/apolipoprotein A-I ratios were associated with more diseased coronaries and complex lesions. Apolipoprotein B/apolipoprotein A-I ratio is a useful tool for acute risk assessment in cardiac ischemic patients.
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