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Galal H, Samir A, Shehata M. Assessment of apolipoprotein B/apolipoprotein A-I ratio in non-ST segment elevation acute coronary syndrome patients. Egypt Heart J. 2020;72(1):27doi: 10.1186/s43044-020-00057-1.
Galal, H., Samir, A., & Shehata, M. (2020). Assessment of apolipoprotein B/apolipoprotein A-I ratio in non-ST segment elevation acute coronary syndrome patients. The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 72(1), 27. https://doi.org/10.1186/s43044-020-00057-1
Galal, Haitham, et al. "Assessment of apolipoprotein B/apolipoprotein A-I ratio in non-ST segment elevation acute coronary syndrome patients." The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology vol. 72,1 (2020): 27. doi: https://doi.org/10.1186/s43044-020-00057-1
Galal H, Samir A, Shehata M. Assessment of apolipoprotein B/apolipoprotein A-I ratio in non-ST segment elevation acute coronary syndrome patients. Egypt Heart J. 2020 May 24;72(1):27. doi: 10.1186/s43044-020-00057-1. PMID: 32449038; PMCID: PMC7246270.
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Egypt Heart J. 2020 May 24;72(1):27. doi: 10.1186/s43044-020-00057-1.

Assessment of apolipoprotein B/apolipoprotein A-I ratio in non-ST segment elevation acute coronary syndrome patients.

The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology

Haitham Galal, Ayman Samir, Mohamed Shehata

Affiliations

  1. Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. [email protected].
  2. Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

PMID: 32449038 PMCID: PMC7246270 DOI: 10.1186/s43044-020-00057-1

Abstract

BACKGROUND: 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.

RESULTS: 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%).

CONCLUSION: 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.

Keywords: Coronary angiography; Lipoproteins; Myocardial infarction

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