June 24, 2019
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HDL apolipoproteomic score may predict risk for CV death in CAD

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An HDL apolipoproteomic score was linked to the presence of CAD in patients without prevalent MI who were referred for coronary angiography, according to a study published in the Journal of the American College of Cardiology.

Pradeep Natarajan, MD, MMSc, director of preventive cardiology at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School, and colleagues analyzed data from 943 patients (mean age, 67 years; 72% men) from the CASABLANCA study who were referred for coronary or peripheral angiography with or without intervention between 2008 and 2011. Patients included in this study did not have prevalent MI.

Blood samples were taken before and after the angiographic procedure to measure HDL-associated apolipoprotein A-I, ApoC-II, ApoC-III and ApoC-IV. Researchers then calculated a composite HDL apolipoproteomic score.

The primary outcome of interest was the presence of coronary stenosis with at least 70% luminal obstruction in at least one major coronary artery. The primary outcome of interest for the incident events analysis was the composite of CV death or MI. Medical records were reviewed for a mean of 4 years.

Of the patients in the study, 62.2% had CAD.

The composite HDL apolipoproteomic score was linked to the presence of obstructive CAD independent of conventional CV risk factors (OR = 1.39; 95% CI, 1.14-1.69). The C-statistic for this score was 0.63 (95% CI, 0.59-0.67).

An HDL apolipoproteomic score was linked to the presence of CAD in patients without prevalent MI who were referred for coronary angiography, according to a study published in the Journal of the American College of Cardiology.
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The composite HDL apolipoproteomic score was not associated with CV mortality in all patients (HR = 1.24; 95% CI, 0.93-1.66), although there was some evidence of a link in patients with obstructive CAD (HR = 1.48; 95% CI, 1.07-2.05).

“Our study highlights that atherosclerosis is influenced by a complex interplay of apolipoproteins across lipoprotein species,” Natarajan and colleagues wrote. “Quantification of these components can inform risk and prognosis.” – by Darlene Dobkowski

Disclosures: The investigator-initiated study was sponsored by Cleveland Heart Labs. Natarajan reports he is supported by an award from the NHLBI; a co-inventor of helical synthetic peptides that stimulate cellular cholesterol efflux; received research grants from Amgen, Apple and Boston Scientific, and received consulting income from and served on a scientific advisory board for Apple. Please see the study for all other authors’ relevant financial disclosures.