Abstract 18732: Elevated Apolipoprotein A2 Adjusted for High-Density Lipoprotein is Associated with Atherosclerotic Burden and Progression in Stable Cardiac Patients
Background: Apolipoprotein A2 (ApoA2), a high-density lipoprotein (HDL) associated protein, has been associated with triglyceride metabolism and insulin resistance in animal models. Despite being the second most abundant protein on HDL particle, its role in humans is unclear. Recent epidemiology study have suggested potential cardioprotective role of ApoA2, but without considering HDL as the confounding factor. We aim to investigate the relationship of genetic and biochemical determinants of ApoA2 after adjusted for HDL cholesterol and atherosclerotic disease burden and progression in humans.
Methods: We examined the relationship between plasma ApoA2 (adjusted for HDL cholesterol) with prevalent cardiovascular diseases (CVD) as well as need for future revascularization up to 3-year follow-up in 4,670 subjects undergoing elective coronary angiography without acute coronary syndromes.
Results: In our cohort (age 63±11 years, 66% male, 79% with CVD, 32% diabetes mellitus), mean ApoA2 level was 32±7mg/dL and highly correlated with HDL (Spearman's r =0.55, p<0.001). While unadjusted ApoA2 levels were inversely associated with greater need for revascularization at 3 years (Hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.87-0.96, p<0.001), higher ApoA2/HDL ratio (mean 0.97±0.23) portends higher rather than lower prevalence of CVD (odds ratio [OR] 1.54; 95%CI 1.42-1.66, p<0.001) and need for future revascularization (HR 1.18; 95%CI 1.13-1.24, p<0.001). After adjusting for traditional risk factors, ApoA2/HDL remained independently predictive of prevalent CVD (OR 1.47, 95%CI 1.35-1.61, p<0.001) and need for future revascularization (HR 1.15, 95%CI 1.09-1.21, p<0.001).
Conclusion: In stable cardiac patients, ApoA2 (when adjusted for HDL) provides independent association with CVD and risk prediction of need for future revascularization, indicating a direct association between ApoA2 with atherosclerotic burden and progression rather than with cardioprotection in humans.
- © 2010 by American Heart Association, Inc.