Discordance analysis for apolipoprotein and lipid measures for predicting myocardial infarction in statin-treated patients with coronary artery disease:a cohort study
Tian-Yu LI1
Pei ZHU2
Ying SONG2
Xiao-Fang TANG2
Zhan GAO2
Run-Lin GAO2
Jin-Qing YUAN3
1.National Clinical Research Center for Cardiovascular Diseases,National Center for Cardiovascular Diseases,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China2.Department of Cardiology,Fuwai Hospital,National Center for Cardiovascular Dis-eases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China3.National Clinical Research Center for Cardiovascular Diseases,National Center for Cardiovascular Diseases,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China;Department of Cardiology,Fuwai Hospital,National Center for Cardiovascular Dis-eases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China
摘要：BACKGROUND The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery dis-ease(CAD)at residual cardiovascular risk remain controversial.This study aimed to compare the predictive powers of apolipo-protein B(apoB),non-high-density lipoprotein cholesterol(non-HDL-C),low-density lipoprotein cholesterol(LDL-C),apoB/apo-lipoprotein A-1(apoA-1)and non-HDL-C/HDL-C for myocardial infarction(MI)in CAD patients treated with statins in the set-ting of secondary prevention.
METHODS The study included 9191 statin-treated CAD patients with a five-year median follow-up.All measures were anal-yzed as continuous variables and concordance/discordance groups by medians.The hazard ratio(HR)with 95%CI was estima-ted by Cox proportional hazards regression.Patients were classified by the clinical presentation of CAD for further analysis.
RESULTS The high-apoB-low-LDL-C and the high-non-HDL-C-low-LDL-C categories yielded HR of 1.40(95%CI:1.04-1.88)and 1.51(95%CI:1.07-2.13)for MI,respectively,whereas discordant high LDL-C with low apoB or non-HDL-C was not associa-ted with the risk of MI.No association of MI with discordant apoB versus non-HDL-C,apoB/apoA-1 versus apoB,non-HDL-C/HDL-C versus non-HDL-C,or apoB/apoA-1 versus non-HDL-C/HDL-C was observed.Similar patterns were found in patients with acute coronary syndrome.In contrast,no association was observed between any concordance/discordance category and the risk of MI in patients with chronic coronary syndrome.
CONCLUSIONS ApoB and non-HDL-C better predict MI in statin-treated CAD patients than LDL-C,especially in patients with acute coronary syndrome.ApoB/apoA-1 and non-HDL-C/HDL-C show no superiority to apoB and non-HDL-C for predict-ing MI.
机标关键词：analysisstudywithapolipoproteinarterycohortcoronarydiscordance
论文发表日期：2023-12-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 845-854 )