J Korean Med Sci.  2013 May;28(5):709-716. 10.3346/jkms.2013.28.5.709.

Association of Apolipoprotein B/Apolipoprotein A1 Ratio and Coronary Artery Stenosis and Plaques Detected by Multi-Detector Computed Tomography in Healthy Population

• Jung CH
• Hwang JY
• Shin MS
• Yu JH
• Kim EH
• Bae SJ
• Yang DH
• Kang JW
• Park JY
• Kim HK
• Lee WJ

• KMID: 1777558
• DOI: http://doi.org/10.3346/jkms.2013.28.5.709

Abstract

Despite the noninvasiveness and accuracy of multidetector computed tomography (MDCT), its use as a routine screening tool for occult coronary atherosclerosis is unclear. We investigated whether the ratio of apolipoprotein B (apoB) to apolipoprotein A1 (apoA1), an indicator of the balance between atherogenic and atheroprotective cholesterol transport could predict occult coronary atherosclerosis detected by MDCT. We collected the data of 1,401 subjects (877 men and 524 women) who participated in a routine health screening examination of Asan Medical Center. Significant coronary artery stenosis defined as > 50% stenosis was detected in 114 subjects (8.1%). An increase in apoB/A1 quartiles was associated with increased percentages of subjects with significant coronary stenosis and noncalcified plaques (NCAP). After adjustment for confounding variables, each 0.1 increase in serum apoB/A1 was significantly associated with increased odds ratios (ORs) for coronary stenosis and NCAP of 1.23 and 1.18, respectively. The optimal apoB/A1 ratio cut off value for MDCT detection of significant coronary stenosis was 0.58, which had a sensitivity of 70.2% and a specificity of 48.2% (area under the curve, 0.61; 95% CI, 0.58-0.63, P < 0.001). Our results indicate that apoB/A1 ratio is a good indicator of occult coronary atherosclerosis detected by coronary MDCT.

Keyword

Apolipoproteins B; Apolipoproteins A1; Coronary Disease; Multidetector Computed Tomography

MeSH Terms

Adult
Aged
Apolipoprotein A-I/*blood
Apolipoproteins B/*blood
Area Under Curve
Carotid Stenosis/*radiography
Coronary Stenosis/*radiography
Female
Humans
Male
Middle Aged
Odds Ratio
ROC Curve
Tomography, X-Ray Computed
Apolipoprotein A-I
Apolipoproteins B

Figure

• 

  Fig. 1 Box-whisker plots of apoB/A1 ratios according to the presence of significant coronary stenosis in total subjects (A), men (B), and women (C). The ends of each whisker indicate the 5th and 95th percentiles of apoB/A1 ratio.

• 

  Fig. 2 Receiver operating characteristic (ROC) curve and optimal apoB/A1 ratio cutoff value (•) for detecting significant coronary stenosis by multidetector computed tomography (MDCT).

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