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.
Atherosclerosis. 2021 Jul;329:44-49. doi: 10.1016/j.atherosclerosis.2021.05.010. Epub 2021 Jun 1.
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.
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.
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).
The LDL-C/ApoB ratio is independently predictive of MACE in subjects with established atherosclerosis.
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。
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。
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）。
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。
