The apolipoprotein B/A1 ratio is associated with reactive oxygen metabolites and endothelial dysfunction in statin-treated patients with coronary artery disease

Abstract

Aim: The prognostic significance of the apolipoprotein B/A1 (ApoB/A1) ratio in statintreated patients with coronary artery disease (CAD) is unknown. We aimed to evaluate the association of the ApoB/A1 ratio with oxidative stress and endothelial dysfunction in these patients. Methods: We enrolled 62 consecutive statin-treated patients who underwent percutaneous coronary intervention (PCI). Their lipid profiles, diacron-reactive oxygen metabolites (d-ROMs), as a marker of oxidative stress, flow-mediated dilatation (FMD), as a marker of vascular endothelial function, and C-reactive protein (CRP) levels, as a marker of inflammation, were measured. Results: Our study population comprised 44 men and 18 women (mean age, 70.5±2.5 years). The ApoB/A1 ratio was positively correlated with the results of the d-ROMs test (p = 0.004, r = 0.36) and CRP level (p = 0.02, r = 0.30) and negatively correlated with the %FMD (p = 0.005, r = -0.40). A multivariate logistic regression analysis showed that the most powerful predictive factor for the d-ROMs was the ApoB/A1 ratio (p = 0.026). We therefore divided patients into two groups according to the cutoff point reported by the INTERHEART study: a low ApoB/A1 ratio (<0.641, n = 26) and a high ApoB/A1 ratio (>0.641, n = 36). The patients with a high ApoB/A1 ratio had higher levels of d-ROMs and CRP, and tended to have a lower %FMD. Conclusion: The ApoB/A1 ratio was associated with the d-ROMs, a marker of oxidative stress, endothelial dysfunction and inflammation, and could be useful as a residual atherosclerotic risk marker to help prevent CAD in statin-treated patients.