Background and aims: Our aim was to examine whether the combined use of apolipoprotein B (apoB)/apolipoprotein A1 (apoA1) and non-high-density lipoprotein cholesterol (non-HDL-C) was useful before routine clinical lipid measurement in predicting coronary heart disease (CHD).
Patients and methods: In total, 826 patients were enrolled and they were classified into a CHD group (532 cases) and a normal group (294 cases) according to the results of coronary angiography. Laboratory data including fasting lipid profile were obtained after an overnight fast. Serum apoB/apoA1 ratio and non-HDL-C were calculated. Logistic regression was applied to estimate the cross-sectional association between the apoB/apoA1 ratio, non-HDL-C, and CHD. Receiver operating characteristics curve analysis was used to determine the value of apoB/apoA1 ratio and non-HDL-C in the diagnosis of CHD.
Results: The associations with an increased risk of CHD were much stronger for the apoB/apoA1 ratio [odds ratio (OR)=8.941, 95% confidence interval (CI) 4.363–18.323] than for non-HDL-C (OR=1.373, 95% CI 1.163–1.622). The patients in the top quartile of the apoB/apoA1 distribution had an OR of 7.321 (95% CI 3.891–13.771) compared with those in the bottom quartile. Patients with combined high levels of apoB/apoA1 and non-HDL-C (N=92, 79.31%) had the highest risk of CHD. The combined use of apoB/apoA1 ratio and non-HDL-C (0.762; 95% CI 0.677–0.847) showed greater receiver operating characteristics area than its individual components or other lipid profiles.
Conclusion: The combination of apoB/apoA1 and non-HDL-C had even greater predictive value than its individual components or other lipid profiles.
Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Correspondence to Zhenyue Chen, MD, PhD, Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197, Ruijin 2nd Road, Shanghai 200025, China Tel: +86 216 437 0045; fax: +86 216 437 2614; e-mail: email@example.com
Received November 18, 2013
Received in revised form January 30, 2014
Accepted February 2, 2014