Clinical & Experimental Cardiology
Open Access

Abstract

Can Apolipoproteins apoB and apoB/apoA1 Ratio Predict Future Cardiovascular Risk Post Acute Coronary Syndrome? A Retrospective Cohort Study

Olivier Desplantie, Krishnan Ramanathan, Stella S Daskalopoulou, Mark Eisenberg, Louise Pilote and Nadia A Khan*

Background: Whether apolipoproteins B100 (ApoB) and ApoB/ApoA1 biomarkers can predict future cardiovascular events in patients with acute coronary syndrome (ACS) is unknown. We evaluated the association between these biomarkers and development of major adverse cardiovascular events within 12 months in patients with ACS.
Methods: We used data from a prospective cohort study of 1149 patients (32% women) aged 55 years or less, hospitalized for ACS (January 2009-April 2013). Baseline ApoB and ApoA1 levels were measured within the first 4 days of hospitalization for ACS. Patients were followed for 12 months for the composite of death, recurrent ACS, need for recurrent revascularization, or re-hospitalization for cardiac causes.
Results: After ACS, most patients had elevated ApoB levels (46% 0.8-1.1 g/L and 31% with >1.1 g/L). Patients with the lowest ApoB levels (<0.8 g/L) were more likely to be women, have a history of previous myocardial infarction, diabetes and to be prescribed statins compared with those with higher ApoB levels. There was no significant association with ApoB level and the risk of composite cardiovascular outcome after adjustment for age, sex, statin use, GRACE score, ACS severity and day of measurement (Hazard Ratio (HR) 0.79, 95% CI: 0.41-1.55). Increasing ApoB/ApoA1 ratio was also not associated with risk of developing composite cardiovascular events compared with lower ratios (HR 0.92 95% CI 0.45-1.87).
Conclusion: ApoB level and ApoB/ApoA1 ratio do not predict future cardiovascular events post-ACS when measured in the first 4 days in patients aged less than 55 years.