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Comparison of apolipoprotein B/A1 ratio, TC/HDL-C, and lipoprotein (a) for predicting outcomes after PCI

Hae Won Jung1, Seung-Pyo Hong1, Kee-Sik Kim1

  • 1Department of Cardiology, Daegu Catholic University Medical Center, Daegu, Korea.

Plos One
|July 13, 2021
PubMed

Insights

The apolipoprotein B/A1 ratio better predicts cardiovascular events after PCI than other markers. A smaller decrease in this ratio indicates a higher risk of major adverse cardiovascular events in patients with low LDL-C.

Area of Science:

  • Cardiology
  • Biochemistry
  • Preventive Medicine

Background:

  • The apolipoprotein B (Apo B)/apolipoprotein A1 (Apo A1) ratio is a key predictor of cardiovascular outcomes.
  • Its comparative predictive value against total cholesterol (TC)/HDL-C and lipoprotein (a) (Lp (a)) after percutaneous coronary intervention (PCI) remains unclear.

Purpose of the Study:

  • To evaluate the predictive impact of the Apo B/A1 ratio on cardiovascular outcomes in patients achieving low LDL-C levels post-PCI.
  • To compare the predictive accuracy of the Apo B/A1 ratio with TC/HDL-C and Lp (a) in this patient cohort.

Main Methods:

  • A cohort of 448 PCI patients with LDL-C below 70 mg/dL at follow-up was analyzed.
  • Apo B/A1 ratio, TC/HDL-C ratio, and Lp (a) levels were measured at baseline and follow-up.
  • Changes in these parameters were assessed for prediction of major cardiovascular adverse events (MACEs).

Main Results:

  • Over a median follow-up of 38 months, 115 MACEs occurred.
  • The lowest decrease in Apo B/A1 ratio (≤ 0.146) was associated with a significantly lower MACE survival rate.
  • No significant differences in MACE survival rates were observed for TC/HDL-C or Lp (a) levels.

Conclusions:

  • The Apo B/A1 ratio demonstrated superior predictive accuracy for clinical outcomes compared to TC/HDL-C and Lp (a).
  • A diminished decrease in the Apo B/A1 ratio may represent a residual risk factor for MACEs in patients who have achieved target LDL-C levels post-PCI.
Abstract

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