Dyslipidemia plays a crucial role in acute coronary syndrome (ACS). Paucity data are available concerning the impact of apolipoprotein (apo) B/ apo A-I ratio on the severity of coronary lesion and outcomes in diabetic patients with ACS. We sought to investigate their associations in a Chinese cohort undergoing percutaneous coronary intervention.
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ABS20191016_0001
| Acute Coronary Syndromes (STEMI, NSTE-ACS) | |
| Apolipoprotein B/A-I Ratio Predicts Lesion Severity and Long-Term Outcomes in Diabetic Patients with Acute Coronary Syndromes | |
| Yue Liu1, Sida Jia1, Deshan Yuan1, Na Xu1, Ru Liu1, Lin Jiang1, Zhan Gao1, Jue Chen2, Yuejin Yang1, Runlin Gao1, Bo Xu1, Jinqing Yuan1 | |
| Fuwai Hospital, China1, Fuwai hospital, China2 | |
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Background:
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Methods:
In 2013, 2563 diabetic patients presenting with ACS were consecutively included. Patients were divided into two groups based on apo B/apo A-I ratio on admission: < 0.63 (n = 1279, 49.9%) and equal to/higher than 0.63 (n = 1284, 50.1%). Angiographic severity was determined by SYNTAX score (SS).
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Results:
Patients with high apo B/apo A-I ratio were younger, had fewer comorbidities, but more glucose and lipid abnormalities. High apo ratio was significantly associated with more onset of acute myocardial infarction (MI) and higher rates of intermediate-high SS. Multivariable logistic regression analysis showed that high apo ratio (OR 1.341, 95% confidence interval 1.039-1.730, p=0.024), presence of acute MI, and low glomerular filtration rate (<60 ml/min) were independent factors of lesion severity. Moreover, consistent results were found in the subgroups of normal concentrations of conventional lipid parameters. During a median follow-up period of 878 days, although two groups had similar survival rates, significant differences were found in periprocedural MI (1.0% versus 2.2%, p=0.019) and total events of MI (2.0% versus 3.3%, p=0.028). After adjusting confounders, high apo B/apo A-I ratio remained independently predictive of MI, the risks of which were doubled during the periprocedural period and in the long term.   |
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Conclusion:
The ratio of Apo B/apo A-I on admission is an independent predictor for lesion severity and recurrent MI in patients with diabetes and ACS, thus, it could aid in risk stratification.
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