Predictive value in ACS patients′ major adverse cardiac events by joint detection of apoB/apoA and non-HDL-C

Zheng Jing; Wan Xiang; Zhu Dong-mei

doi:10.3969/j.issn.1002-1949.2017.09.010

Abstract：Objective To explore the predictive value in acute coronary syndrome(ACS) patients′ major adverse cardiac events(MACE) by joint detection of apolipoprotein B/apolipoprotein A(apoB/apoA) and non-high density lipoprotein cholesterol(non-HDL-C), to provide reference to its clinical diagnosis, treatment and evaluation.Methods 120 cases with ACS were selected, and blood lipid indexes were detected under the condition of unused lipid-lowering drugs, including cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), apoB, apoA, and non-HDL-C was calculated by Frost formula.The cut-off point of non-HDL-C was defined as 130 mg/dL(3.38 mmol/L), apoB/apoA′s cut-off point was defined as 0.9, and the patients were divided into 4 subgroups by above cut-off points, and group A with 37 cases, group B with 38 cases, group C with 32 cases, group D with 13 cases, and they were followed up for 6 months to record MACE.Results There was 118 cases of effective subjects, including 68 cases in group of apoB/apoA≤0.9, 50 cases in group of apoB/apoA > 0.9, 74 cases in group of non-HDL-C≤3.38 mmol/L, and 44 cases in group of non-HDL-C>3.38 mmol/L.Comparing between groups of apoB/apoA > 0.9 and apoB/apoA ≤0.9, non-HDL-C>3.38 mmol/L and non-HDL-C≤3.38 mmol/L, there were statistical differences on complicating with diabetes mellitus, complicating with hypertension, HDL-C, apoB, apoB/apoA and non-HDL-C(χ2/t=3.97~5.20, P<0.05).MACE′s incidence in group B, C and D were all higher than that in group A(χ2 =5.10, 11.83, 25.74, P<0.05 or P<0.01), and MACE′s incidence in group D were both higher than that in group B and C(χ2 =13.82, 7.45, P<0.01).Multifactor Logistic regression analysis showed that, non-HDL-C and apoB /apoA both had predictive value for MACE, and it had stronger predictive value for MACE by joint detection of apoB/apoA and non-HDL-C(both at high level, 95% CI 3.211~57.621, P<0.01).Conclusion ApoB /apoA and non-HDL-C can more comprehensively reflect the change of lipoprotein metabolism, and has some predictive value on MACE in patients with ACS, and has stronger predictive value by joint detection(both at high level), so it has some guiding significance and reference value on ACS patients′ clinical diagnosis, treatment and prognosis evaluation.