载脂蛋白 B 与 LDL-C 比值可预测已确诊动脉粥样硬化性心血管疾病患者的主要心血管事件。
The LDL-C/ApoB ratio predicts major cardiovascular events in patients with established atherosclerotic cardiovascular disease.
机构信息
Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, 6800, Feldkirch, Austria; Private University in the Principality of Liechtenstein, Dorfstraße 24, 9495, Triesen, Liechtenstein; Department of Internal Medicine, Landeskrankenhaus Bregenz, Carl-Pedenz-Straße 2, 6900, Bregenz, Austria; Drexel University College of Medicine, 2900W Queen Lane, Philadelphia, 19129, USA.
Department of Medicine I, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, 6800, Feldkirch, Austria; Private University in the Principality of Liechtenstein, Dorfstraße 24, 9495, Triesen, Liechtenstein.
出版信息
Atherosclerosis. 2021 Jul;329:44-49. doi: 10.1016/j.atherosclerosis.2021.05.010. Epub 2021 Jun 1.
BACKGROUND AND AIMS
The low density lipoprotein cholesterol to Apolipoprotein B (LDL-C/ApoB) ratio is a validated proxy for low density lipoprotein (LDL) particle size that can be easily calculated from a standard lipid/apolipoprotein profile. Whether it is predictive of cardiovascular events in patients with established atherosclerosis is not known and is addressed in the present investigation.
METHODS
We determined the LDL-C/ApoB ratio in a cohort of 1687 subjects with established atherosclerosis. Prospectively, major cardiovascular events (MACE) including cardiovascular death, non-fatal myocardial infarction and non-fatal stroke were recorded over a period of 9.9 ± 4.6 years. The study covers >16,000 patient-years.
RESULTS
At baseline, the LDL-C/ApoB ratio was 1.36 ± 0.28 in our cohort. During follow up, a total of 558 first MACE were recorded. The LDL-C/ApoB ratio predicted MACE in univariate Cox proportional hazard analysis (HR 0.90 [0.82-0.98]; p = 0.014); this finding was confirmed after adjustment for age, gender, intensity of statin treatment, hypertension, history of smoking, type 2 diabetes, body mass index and ApoB (HR 0.87 [0.78-0.97]; p = 0.013).
CONCLUSIONS
The LDL-C/ApoB ratio is independently predictive of MACE in subjects with established atherosclerosis.
背景与目的
载脂蛋白 B 与低密度脂蛋白胆固醇（LDL-C/ApoB）比值是一种经过验证的 LDL 颗粒大小的替代指标，可通过标准脂质/载脂蛋白谱轻松计算得出。其在已确诊动脉粥样硬化患者的心血管事件中的预测价值尚不清楚，本研究旨在对此进行探讨。
方法
我们在一个有明确动脉粥样硬化的 1687 名患者队列中确定了 LDL-C/ApoB 比值。前瞻性地，在 9.9±4.6 年的随访期间，记录了主要心血管事件（MACE），包括心血管死亡、非致死性心肌梗死和非致死性卒中。该研究涵盖超过 16000 患者年。
结果
在基线时，我们队列中的 LDL-C/ApoB 比值为 1.36±0.28。在随访期间，共记录了 558 例首次 MACE。单变量 Cox 比例风险分析显示 LDL-C/ApoB 比值可预测 MACE（HR 0.90 [0.82-0.98]；p=0.014）；在调整年龄、性别、他汀类药物治疗强度、高血压、吸烟史、2 型糖尿病、体重指数和 ApoB 后，这一发现仍然成立（HR 0.87 [0.78-0.97]；p=0.013）。
结论
在已确诊动脉粥样硬化的患者中，LDL-C/ApoB 比值是 MACE 的独立预测因子。
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