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Elevated ApoB/apoA-1 is Associated with in-Hospital Mortality in Elderly Patients with Acute Myocardial Infarction
Yan Chen1, Shengyue Chen1, Yuanyuan Han1
1Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China.
Insights
The apolipoprotein B/apolipoprotein A-1 (apoB/apoA-1) ratio is linked to in-hospital death risk in elderly acute myocardial infarction (AMI) patients. This ratio shows predictive value and a dose-response relationship for mortality in this vulnerable group.
Area of Science:
- Cardiology
- Biomarkers
- Geriatric Medicine
Background:
- The apolipoprotein B/apolipoprotein A-1 (apoB/apoA-1) ratio is a known cardiovascular disease risk marker.
- Its association with in-hospital mortality in elderly patients with acute myocardial infarction (AMI) remains unclear.
Purpose of the Study:
- To investigate the relationship between the apoB/apoA-1 ratio and in-hospital death risk in elderly AMI patients.
- To assess the predictive capability of the apoB/apoA-1 ratio for in-hospital mortality.
Main Methods:
- A cohort of 1495 elderly AMI patients (≥ 60 years) was studied from December 2015 to December 2021.
- Multivariate logistic regression and restricted spline cubic (RCS) models analyzed the association with in-hospital mortality.
- Receiver operating characteristic (ROC) curves evaluated the predictive value of the apoB/apoA-1 ratio.
Main Results:
- A total of 128 patients (8.6%) died during hospitalization.
- Higher apoB/apoA-1 ratios were observed in non-survivors compared to survivors (P < 0.05).
- The apoB/apoA-1 ratio was significantly associated with in-hospital death risk (OR = 3.524, P = 0.001) and showed predictive value (AUC = 0.572, P = 0.011).
Conclusions:
- The apoB/apoA-1 ratio is a significant predictor of in-hospital mortality in elderly AMI patients.
- This lipid ratio demonstrates a linear dose-response relationship with in-hospital death.
- The apoB/apoA-1 ratio appears superior to other lipid parameters for predicting mortality in this population.
Background:
Apolipoprotein B/apolipoprotein A-1 (apoB/apoA-1) has been shown to be strongly associated with the risk of future cardiovascular disease, but the association between apoB/apoA-1 and the risk of in-hospital death in elderly patients with acute myocardial infarction(AMI) is inconclusive.
Aim:
To investigate the association between apoB/apoA-1 and the risk of in-hospital death in elderly patients with AMI.
Methods:
From December 2015 to December 2021, a total of 1495 elderly AMI patients (aged ≥ 60 years) with complete clinical history data were enrolled in the Second Hospital of Dalian Medical University. Outcome was defined as all-cause mortality during hospitalization. Multivariate logistic regression and restricted spline cubic (RCS) models were used to evaluate the association between apoB/apoA-1 and in-hospital mortality risk, respectively. Receiver operating characteristic(ROC) curves were used to evaluate the predictive value of apoB/apoA-1 for in-hospital mortality events. Discordance analysis was performed when apoB/apoA-1 and LDL-C/HDL-C were not in concordance.
Results:
(1) A total of 128 patients (8.6%) died during hospitalization. Patients in the death group had higher apoB/apoA-1 than those in the non-death group, but lower apoA-1 levels than those in the non-death group, and the difference was statistically significant (P < 0.05); (2) Multivariate logistic regression analysis showed that apoB/apoA-1 was associated with the risk of in-hospital death in elderly AMI patients [Model 3 OR = 3.524 (1.622-7.659), P = 0.001]; (3) ROC curve analysis showed that apoB/apoA-1 (AUC = 0.572, P = 0.011) had some predictive value for the risk of in-hospital death in elderly AMI patients; (4) RCS models showed a linear dose-response relationship between apoB/apoA-1 and in-hospital death after adjusting for confounders (P for non-linearity = 0.762).
Conclusion:
ApoB/apoA-1 is associated with the risk of in-hospital death in elderly patients with AMI, and is superior to other blood lipid parameters and blood lipid ratio.
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