Prognostic implications of calculated Apo‐lipoprotein B in patients with ST‐segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: Outcome is tied to lower cut‐points

Abstract

Background Debates still surround using lipoproteins including Apo‐B in risk assessment, management, and prognosis of patients with coronary artery disease. During an acute ST‐segment elevation myocardial infarction, Apo‐B might help to achieve incremental prognostic information. Objective We sought to determine the potential prognostic utility of calculated Apo‐B in a cohort of patients with STEMI undergoing primary PCI. Methods A retrospective cohort study was conducted enrolling 2,259 patients with a diagnosis of acute STEMI who underwent primary PCI. Apo‐B was obtained using a valid equation based on initial lipid measurements. High Apo‐B was defined as a level of 65 or higher. Primary endpoint of the study was major adverse cardiovascular events (MACE). Results Mean age of the participants was 59.54 years and 77.9% of them were male. After a Median follow up of 15 (6.2) months, high Apo‐B was associated with MACE and the OR (95% CI) was 3.02 (1.07–8.47), p = .036. Odds ratios for prediction of MACE pertaining to LVEF, and smoking were 0.97 (p = .044), and 1.07 (p = .033), respectively. However, High Apo‐B was not able to predict suboptimal TIMI flow. Accordingly, the Odds ratio was 0.56 (0.17–1.87), p = 0.349. The power of High LDL‐C and Non‐HDLC for prediction of MACE were assessed in distinct models. Attained odds ratios were [2.40 (0.90–6.36), p = .077] and [1.80 (0.75–4.35), p = 0.191], respectively. Conclusion Calculated Apo‐B appears to be a simple tool applicable for prediction of cardiovascular events in patients with STEMI superior to both Non‐HDLC and LDL‐C.

Serum apolipoprotein B to apolipoprotein A‐I ratio predicts mortality in patients with heart failure

“…High ApoB was associated with an increased risk of major adverse cardiovascular events (MACEs) in patients with a diagnosis of acute STEMI who underwent primary PCI. 35 Li et al found that the ApoB < 65 mg/day group had a 10% lower risk of long‐term all‐cause mortality when compared with CHD patients with ApoB ≥ 65 mg/dL. 36 Similarly, lower achieved apoB was demonstrated related to lower risk of MACEs in a large population study conducted by Emil et al 37 Besides, a higher level of ApoB was connected with a higher risk of HF.…”

“…Serum apolipoprotein B to apolipoprotein A-I ratio predicts mortality in patients with heart failure ApoB, which is a key structural element of atherogenic lipoprotein particles including LDL, lipoprotein(a), and triglyceride-rich lipoproteins, is synthesized in the liver and facilitates and amplifies cholesterol transfer in a cycle streaming from the liver to peripheral tissues. 35 A substantial of studies have identified ApoB as the bad apolipoprotein. High ApoB was associated with an increased risk of major adverse cardiovascular events (MACEs) in patients with a diagnosis of acute STEMI who underwent primary PCI.…”

“…ApoB, which is a key structural element of atherogenic lipoprotein particles including LDL, lipoprotein(a), and triglyceride‐rich lipoproteins, is synthesized in the liver and facilitates and amplifies cholesterol transfer in a cycle streaming from the liver to peripheral tissues 35 . A substantial of studies have identified ApoB as the bad apolipoprotein.…”

“…A substantial of studies have identified ApoB as the bad apolipoprotein. High ApoB was associated with an increased risk of major adverse cardiovascular events (MACEs) in patients with a diagnosis of acute STEMI who underwent primary PCI 35 . Li et al found that the ApoB < 65 mg/day group had a 10% lower risk of long‐term all‐cause mortality when compared with CHD patients with ApoB ≥ 65 mg/dL 36 .…”

Apolipoprotein B - An ideal biomarker for atherosclerosis?

“… 60 Serum level of Lp (a) and serum level of Apo-B showed higher significant prediction for occurrence of CVD. Ghodsi S, 2021 32 Not mentioned Cohort study Coronary heart disease To determine the potential prognostic utility of calculated Apo-B in a cohort of patients with STEMI undergoing primary PCI. NA 2259 Compared to non-HDLC and LDL-C, Apo B appears to be a simple tool for prediction of cardiovascular events in STEMI patients.…”