Abstract 17747: Low Apolipoprotein A1 Predicts 10year-Cardiovascular Mortality in Patients Undergoing Percutaneous Coronary Intervention With or Without Statin Therapy, a Possible Useful Biomarker and Residual Therapeutic Target in the Statin Era
Despite pharmacotherapeutic interventions targeting LDL-cholesterol (LDL-C) by statins, cardiovascular mortality remains high in patients with coronary artery disease (CAD). Parameters of lipoproteins (apolipoprotein (Apo) B100, Apo A1 and their ratio) were previously demonstrated to offer better prognostic value for adverse outcomes in patients with acute coronary syndromes (ACS). However, its clinical utility for long-term prognosis is not fully established. This study thus aimed to address prognostic implication of apolipoproteins in patients with stable CAD, as well as ACS.
Methods and results: This is a retrospective analysis of a single-center prospective database consisting 3831 patients undergone PCI since 1984 to 2010. The present study enrolled 2170 patients whose data of both ApoA1 and ApoB are available, including 604 ACS patients (27.8%). Median follow-up period was 6.89 years (range: 0.01-10.9 years). Multivariate analysis using Cox proportional hazard model demonstrated low ApoA1 (1st quartile) is a significant indicator for cardiovascular mortality (Hazard ratio: 1.60, 95% confidential interval: 1.18-2.15, p=0.002), while high ApoB100, and high ApoB100/ApoA1 ratio were not. Moreover, Kaplan-Meier survival analysis showed higher cumulative incidence of CV death in patients having low ApoA1 with and without statin therapy (Figure A). Similarly, significant high hazard ratio was maintained in the population receiving statin therapy (Figure B).
Conclusions: Findings in this study may indicate ApoA1, as not only a useful prognostic indicator in patients with CAD, but also a residual therapeutic target in CAD patients beyond LDL.
Author Disclosures: H. Nishiyama: None. H. Iwata: None. R. Naito: None. H. Endo: None. T. Shimizu: None. S. Doi: None. S. Tsuboi: None. M. Ogita: None. T. Dohi: None. H. Tamura: None. S. Okazaki: None. K. Isoda: None. K. Miyauchi: None. H. Daida: None.
- © 2016 by American Heart Association, Inc.