Serum palmitic acid-oleic acid ratio and the risk of coronary artery disease: a case-control study.

Serum free fatty acids are risk factors for future coronary artery disease (CAD). We investigated the association between serum palmitic acid (PA)-oleic acid (OA) ratio and CAD risk in a case-control (n=108/129) study. The PA-OA ratio was associated with future CAD events independently of standard lipid values. The PA-OA ratio was significantly associated with the risk of fatal CAD [odds ratio (OR): 60.4; 95% confidence interval (CI): 11.5-316.9; P<.001] while inversely associated in nonfatal CAD group (OR: 0.11; 95% CI: 0.02-0.53; P<.01), and no distinct modification by sex was found. Receiver-operating characteristic (ROC) analysis found that PA-OA ratio did as well as triglyceride (TG) and apolipoprotein B (apo B)-high-density lipoprotein cholesterol (HDLC) ratio at discriminating fatal CAD (area under ROC, TG, 0.692; apo B-HDLC, 0.683; PA-OA, 0.768, P<.001), and had similar effect with HDLC at discriminating nonfatal CADs (area under ROC, HDLC, 0.649; PA-OA, 0.659, P<.01).These findings suggested that PA-OA ratio did as well as and even better than traditional risk factors and arteriography examination in discriminating fatal and nonfatal CAD events. Serum PA-OA ratio could be a new factor for CAD risk assessment and prediction.