Apolipoprotein C3 and necrotic core volume are correlated but also associated with future cardiovascular events

Area of Science:

• Cardiovascular Medicine
• Biochemistry
• Medical Imaging

Background:

• Stable coronary disease (SCD) management involves understanding plaque vulnerability.
• Apolipoprotein C3 (apo-C3) role in plaque composition and cardiovascular events needs further clarification.
• Percutaneous coronary intervention (PCI) is a common treatment for SCD.

Purpose of the Study:

• To determine the association between apo-C3 levels and coronary plaque characteristics.
• To investigate the relationship between apo-C3 and major adverse cardiovascular events (MACEs) within 4 years post-PCI.
• To evaluate apo-C3 as a potential predictor of MACEs in SCD patients.

Main Methods:

• Analysis of 98 SCD patients undergoing PCI.
• Laboratory assessment of apo-C3 levels.
• Virtual histology-intravascular ultrasound (VH-IVUS) for plaque composition analysis (necrotic core volume - %NC).
• Kaplan-Meier and multivariate Cox hazard analyses for MACE prediction.

Main Results:

• Higher apo-C3 levels correlated with increased necrotic core volume (%NC) in culprit lesions.
• High apo-C3 group showed significantly higher %NC compared to the low apo-C3 group.
• High apo-C3 and high %NC were independent predictors of 4-year MACEs.
• Patients with high apo-C3 or high %NC had a greater risk of MACEs.

Conclusions:

• Apolipoprotein C3 is associated with vulnerable plaque characteristics (higher %NC) in SCD patients.
• Elevated apo-C3 levels are predictive of future MACEs in patients with SCD after PCI.
• Apo-C3 may serve as a valuable biomarker for assessing MACE risk in this population.