Gabriel Vázquez-Oliva1, Alberto Zamora2, Rafel Ramos3, Isaac Subirana4, María Grau5, Irene R Dégano6, Daniel Muñoz7, Montserrat Fitó7, Roberto Elosua6, Jaume Marrugat8. 1. Departamento de Cardiología, Fundación Althaia, Manresa, Barcelona, Spain; Facultad de Medicina, Universidad de Girona, Girona, Spain. 2. Facultad de Medicina, Universidad de Girona, Girona, Spain; Unidad de Riesgo Vascular, Hospital de Blanes, Corporación de Salud del Maresme y la Selva, Blanes, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain. 3. Facultad de Medicina, Universidad de Girona, Girona, Spain; Instituto Universitario de Investigación en Atención Primaria (IDIAP) Jordi Gol, Grupo de Investigación ISV, Unidad de Investigación en Atención Primaria, Girona, Spain; Atención Primaria, Instituto Catalán de Salud (ICS), Girona, Spain. 4. Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. 5. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain. 6. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Universidad de Vic-Central de Cataluña (UVic-UCC), Vic, Barcelona, Spain. 7. Grupo de Nutrición y Riesgo Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain. 8. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain. Electronic address: jmarrugat@imim.es.
Abstract
INTRODUCTION AND OBJECTIVES: New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function. METHODS: A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths. RESULTS: Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048). CONCLUSIONS: Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions.
INTRODUCTION AND OBJECTIVES: New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function. METHODS: A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths. RESULTS: Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048). CONCLUSIONS: Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions.
Authors: Vasiliy S Chernyshev; Roman N Chuprov-Netochin; Ekaterina Tsydenzhapova; Elena V Svirshchevskaya; Rimma A Poltavtseva; Anastasiia Merdalimova; Alexey Yashchenok; Amiran Keshelava; Konstantin Sorokin; Varlam Keshelava; Gennadiy T Sukhikh; Dmitry Gorin; Sergey Leonov; Mikhail Skliar Journal: J Extracell Vesicles Date: 2022-08