Abstract 1079: Impact of Apolipoprotein B/AI Ratio on Clinical Outcome After Percutaneous Coronary Intervention: Insight From Integrated Backscatter Intravascular Ultrasound
Background: Apolipoprotein B/AI(apoB/AI)ratio has been shown to predict the risk of cardiovascular disease. However, predictive value of apoB/AI ratio on clinical outcome after percutaneous coronary intervention(PCI)is not known. In this study using integrated backscatter intravascular ultrasound(IB-IVUS), we assessed the impact of apoB/AI ratio on coronary events after PCI, taking coronary tissue characterization into consideration.
Methods: Conventional and IB-IVUS using 40-MHz(motorized pullback 0.5mm/s)intravascular catheter were performed to 160 consecutive patients who underwent PCI from April 2007 to December 2008. The percentage of lipid area and fibrous area were automatically calculated by IB-IVUS system. Three-demensional analysis of IB-IVUS was performed to determine the percentage of lipid volume(%LV) and fibrous volume(%FV). Lipid-rich plaque(LRP)was then defined as greater %LV(>75th percentile). Patients were stratified into two groups according to apoB/AI ratio. Coronary events were defined as death, nonfatal myocardial infarction, and any revasculariza-tion.
Results: During follow-up period(mean 334days),30(19%)coronary events(including 5% revascularization for target lesions and 14% for new lesions)were observed. In Kaplan-Meier analysis, coronary events were significantly increased in patients with higher apoB/AI ratio(>75th percentile) compared to those with lower(p=0.001 by log-rank test). LRP was significantly increased in patients with higher apoB/AI ratio as compared to their counter-part(p=0.001). In multivariate logistic model after adjusting confounding and coronary risk factors, higher apoB/AI ratio was significantly associated with LRP(OR 4.36,95%CI 1.81–9.48, p=0.001).
Conclusions: Elevated apoB/AI ratio would predict higher coronary events, and is also significantly associated with LRP measured by IB-IVUS. These results may explain the contribution of apoB/AI ratio to the increased risk of coronary events after PCI.