Galal Haitham, Samir Ayman, Shehata Mohamed
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Egypt Heart J. 2020 May 24;72(1):27. doi: 10.1186/s43044-020-00057-1.
The apolipoprotein B/apolipoprotein A-I ratio was shown to be strongly related to the risk of myocardial infarction in several large-scale studies. The current study aimed at exploring the diagnostic and short-term prognostic values of apolipoprotein B/apolipoprotein A-I ratio in patients presenting with non-ST segment elevation acute coronary syndrome. One hundred patients with non-ST segment elevation acute coronary syndrome were prospectively enrolled, in addition to a matched group of 100 patients with chronic stable angina. Serum levels of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, and apolipoproteins B and A-I were quantified in both groups. Patients with non-ST segment elevation acute coronary syndrome underwent coronary angiography.
The mean age of the study population was 57 ± 6 years, 65% being males. The non-ST segment elevation acute coronary syndrome group showed significantly unfavorable lipid profile parameters, including apolipoprotein B/apolipoprotein A-I ratio. Higher apolipoprotein B/apolipoprotein A-I ratio was associated with more coronaries showing significant stenosis and more complex lesion morphology. Receiver operating characteristic curve analysis reached an optimal cut-off value of 0.93 for diagnosis of non-ST segment elevation acute coronary syndrome (sensitivity 70% and specificity 88%) and 0.82 for predicting the presence of multi-vessel disease (sensitivity 90% and specificity 97%).
Apolipoprotein B/apolipoprotein A-I ratio is a useful tool of risk assessment in patients presenting with non-ST segment elevation acute coronary syndrome including prediction of coronary multivessel affection. Apolipoprotein B/apolipoprotein A-I ratio was shown to be strongly related to risk of myocardial infarction. Higher ratios of apolipoprotein B/apolipoprotein A-I were recorded in NSTE-ACS patients (versus stable angina patients). Higher apolipoprotein B/apolipoprotein A-I ratios were associated with more diseased coronaries and complex lesions. Apolipoprotein B/apolipoprotein A-I ratio is a useful tool for acute risk assessment in cardiac ischemic patients.
在多项大规模研究中，载脂蛋白B/载脂蛋白A-I比值与心肌梗死风险密切相关。本研究旨在探讨载脂蛋白B/载脂蛋白A-I比值在非ST段抬高型急性冠状动脉综合征患者中的诊断及短期预后价值。前瞻性纳入了100例非ST段抬高型急性冠状动脉综合征患者，另外匹配了100例慢性稳定型心绞痛患者作为对照组。对两组患者的总胆固醇、低密度脂蛋白、高密度脂蛋白、甘油三酯以及载脂蛋白B和A-I的血清水平进行了定量检测。非ST段抬高型急性冠状动脉综合征患者接受了冠状动脉造影检查。
研究人群的平均年龄为57±6岁，男性占65%。非ST段抬高型急性冠状动脉综合征组的血脂谱参数明显较差，包括载脂蛋白B/载脂蛋白A-I比值。较高的载脂蛋白B/载脂蛋白A-I比值与更多显示严重狭窄的冠状动脉以及更复杂的病变形态相关。受试者工作特征曲线分析得出，诊断非ST段抬高型急性冠状动脉综合征的最佳截断值为0.93（敏感性70%，特异性88%），预测多支血管病变存在的最佳截断值为0.82（敏感性90%，特异性97%）。
载脂蛋白B/载脂蛋白A-I比值是评估非ST段抬高型急性冠状动脉综合征患者风险的有用工具，包括预测冠状动脉多支血管受累情况。载脂蛋白B/载脂蛋白A-I比值与心肌梗死风险密切相关。非ST段抬高型急性冠状动脉综合征患者（与稳定型心绞痛患者相比）的载脂蛋白B/载脂蛋白A-I比值更高。较高的载脂蛋白B/载脂蛋白A-I比值与更多病变冠状动脉和复杂病变相关。载脂蛋白B/载脂蛋白A-I比值是评估心脏缺血患者急性风险的有用工具。
