Abstract 18449: Apolipoprotein B/Apolipoprotein A-I Ratio and Progression of Aortic Valve Stenosis - Results From the PROGRESSA Study
Introduction: Calcific aortic stenosis (AS) is an active and complex disorder, which involves atherosclerotic-like processes. However, previous studies reported that the association between atherosclerotic risk factors and AS progression appears to be stronger in younger middle-aged patients compared to elderly ones.
Hypothesis: Apolipoprotein B/apolipoprotein A-I (apoB/apoA-I) ratio reflects the balance between proatherogenic versus antiatherogenic lipid profile. The objective of this study was to examine the association between apoB/apoA-I ratio and progression of AS according to patient’s age.
Methods: One hundred sixty five patients with AS were prospectively recruited in the PROGRESSA study. AS progression was assessed by increase in peak aortic jet velocity (Vpeak) measured by Doppler echocardiography between baseline and 2-year follow-up. Blood samples were collected to measure plasma levels of apoB and apoA-I.
Results: The mean age was 66±13 years and 72% were male. During the 2-year follow-up, AS progression was similar in younger patients (age <69 y.o. [median age for the whole cohort]; n=82) and older patients (Vpeak: +0.24±0.04 vs +0.25±0.03 m/s; p=0.82). There was a significant interaction (p<0.01) between patient’s age and baseline apoB/apoA-I ratio for AS progression. Younger patients with high baseline apoB/apoA-I ratio (i.e. apoB/apoA-I ≥0.53; n=41) had faster AS progression compared to those with lower apoB/apoA-I ratio (Vpeak: +0.32±0.06 vs +0.16±0.04 m/s; p=0.03). In older patients, there was no significant association between apoB/apoA-I ratio and AS progression (Vpeak: +0.23±0.05 vs +0.27±0.04 m/s; p=0.55). After adjustment for sex, hypertension, dyslipidemia, diabetes, metabolic syndrome, creatinine level, degree of aortic valve calcification and baseline Vpeak, higher apoB/apoA-I ratio remained independently associated with faster progression of AS in younger patients (p=0.003).
Conclusions: This prospective study shows for the first time that higher apoB/apoA-I ratio is a powerful and independent predictor of faster AS progression in younger patients. These findings suggest that the pathological processes involved in the progression of AS are different in younger versus older patients.
Author Disclosures: L. Tastet: None. R. Capoulade: None. M. Shen: None. A. Dahou: None. M.A. Clavel: None. P. Mathieu: None. M. Arsenault: None. É. Bédard: None. J.G. Dumesnil: None. J.P. Després: Research Grant; Significant; Canadian Institutes of Health Research (CIHR). Speakers Bureau; Significant; Pfizer Canada;Merck; AstraZeneda; Abbott Laboratories. Consultant/Advisory Board; Significant; Abbott Laboratories: Sanofi; Torernt Pharmaceuticals. P. Pibarot: None.
- © 2015 by American Heart Association, Inc.