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Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study
BACKGROUND: Total occlusion is the most severe coronary lesion, indicating heavy ischemic burden and poor prognosis. The lipid profile is central to the development of atherosclerotic coronary lesions. Evidence on the optimal lipid measure to be monitored and managed in patients with established cor...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650853/ https://www.ncbi.nlm.nih.gov/pubmed/36369093 http://dx.doi.org/10.1186/s12944-022-01733-8 |
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author | Li, Tianyu Yuan, Deshan Wang, Peizhi Jia, Sida Zhang, Ce Zhu, Pei Song, Ying Tang, Xiaofang Zhao, Xueyan Gao, Zhan Yang, Yuejin Gao, Runlin Xu, Bo Yuan, Jinqing |
author_facet | Li, Tianyu Yuan, Deshan Wang, Peizhi Jia, Sida Zhang, Ce Zhu, Pei Song, Ying Tang, Xiaofang Zhao, Xueyan Gao, Zhan Yang, Yuejin Gao, Runlin Xu, Bo Yuan, Jinqing |
author_sort | Li, Tianyu |
collection | PubMed |
description | BACKGROUND: Total occlusion is the most severe coronary lesion, indicating heavy ischemic burden and poor prognosis. The lipid profile is central to the development of atherosclerotic coronary lesions. Evidence on the optimal lipid measure to be monitored and managed in patients with established coronary artery disease (CAD) is inconclusive. METHODS: Total cholesterol (TC), total triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), nonhigh-density lipoprotein cholesterol (non-HDL-c), lipoprotein (a) [Lp(a)], apolipoprotein B (apoB), non-HDL-c/HDL-c, and apoB/apoA-1 were analyzed in quintiles and as continuous variables. The associations of lipid measures with total occlusion were tested using logistic regression models, visualized with restricted cubic splines, and compared by areas under the receiver operating characteristic curves (AUROC). Discordance analysis was performed when apoB/apoA-1 and non-HDL-c/HDL-c were not in concordance. RESULTS: The prospective cohort study included 10,003 patients (mean age: 58 years; women: 22.96%), with 1879 patients having total occlusion. The risks of total occlusion significantly increased with quintiles of Lp(a), non-HDL-c/HDL-c, and apoB/apoA-1 (all p for trend < 0.001). TG had no association with total occlusion. Restricted cubic splines indicate significant positive linear relations between the two ratios and total occlusion [odds ratio per 1-standard deviation increase (95% confidence interval): non-HDL-c/HDL-c: 1.135 (1.095–1.176), p < 0.001; apoB/apoA-1: 2.590 (2.049–3.274), p < 0.001]. The AUROCs of apoB/apoA-1 and non-HDL-c/HDL-c were significantly greater than those of single lipid measures. Elevation in the apoB/apoA-1 tertile significantly increased the risk of total occlusion at a given non-HDL-c/HDL-c tertile but not vice versa. CONCLUSION: ApoB/apoA-1 confers better predictive power for total occlusion than non-HDL-c/HDL-c and single lipid measures in established CAD patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12944-022-01733-8. |
format | Online Article Text |
id | pubmed-9650853 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96508532022-11-15 Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study Li, Tianyu Yuan, Deshan Wang, Peizhi Jia, Sida Zhang, Ce Zhu, Pei Song, Ying Tang, Xiaofang Zhao, Xueyan Gao, Zhan Yang, Yuejin Gao, Runlin Xu, Bo Yuan, Jinqing Lipids Health Dis Research BACKGROUND: Total occlusion is the most severe coronary lesion, indicating heavy ischemic burden and poor prognosis. The lipid profile is central to the development of atherosclerotic coronary lesions. Evidence on the optimal lipid measure to be monitored and managed in patients with established coronary artery disease (CAD) is inconclusive. METHODS: Total cholesterol (TC), total triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), nonhigh-density lipoprotein cholesterol (non-HDL-c), lipoprotein (a) [Lp(a)], apolipoprotein B (apoB), non-HDL-c/HDL-c, and apoB/apoA-1 were analyzed in quintiles and as continuous variables. The associations of lipid measures with total occlusion were tested using logistic regression models, visualized with restricted cubic splines, and compared by areas under the receiver operating characteristic curves (AUROC). Discordance analysis was performed when apoB/apoA-1 and non-HDL-c/HDL-c were not in concordance. RESULTS: The prospective cohort study included 10,003 patients (mean age: 58 years; women: 22.96%), with 1879 patients having total occlusion. The risks of total occlusion significantly increased with quintiles of Lp(a), non-HDL-c/HDL-c, and apoB/apoA-1 (all p for trend < 0.001). TG had no association with total occlusion. Restricted cubic splines indicate significant positive linear relations between the two ratios and total occlusion [odds ratio per 1-standard deviation increase (95% confidence interval): non-HDL-c/HDL-c: 1.135 (1.095–1.176), p < 0.001; apoB/apoA-1: 2.590 (2.049–3.274), p < 0.001]. The AUROCs of apoB/apoA-1 and non-HDL-c/HDL-c were significantly greater than those of single lipid measures. Elevation in the apoB/apoA-1 tertile significantly increased the risk of total occlusion at a given non-HDL-c/HDL-c tertile but not vice versa. CONCLUSION: ApoB/apoA-1 confers better predictive power for total occlusion than non-HDL-c/HDL-c and single lipid measures in established CAD patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12944-022-01733-8. BioMed Central 2022-11-11 /pmc/articles/PMC9650853/ /pubmed/36369093 http://dx.doi.org/10.1186/s12944-022-01733-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Li, Tianyu Yuan, Deshan Wang, Peizhi Jia, Sida Zhang, Ce Zhu, Pei Song, Ying Tang, Xiaofang Zhao, Xueyan Gao, Zhan Yang, Yuejin Gao, Runlin Xu, Bo Yuan, Jinqing Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study |
title | Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study |
title_full | Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study |
title_fullStr | Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study |
title_full_unstemmed | Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study |
title_short | Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study |
title_sort | associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650853/ https://www.ncbi.nlm.nih.gov/pubmed/36369093 http://dx.doi.org/10.1186/s12944-022-01733-8 |
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