Jing Cao1, Sarah O Nomura2, Brian T Steffen2, Weihua Guan3, Alan T Remaley4, Amy B Karger2, Pamela Ouyang5, Erin D Michos5, Michael Y Tsai6. 1. Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Pathology, Texas Children's Hospital, Houston, TX, USA. 2. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA. 3. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA. 4. Lipoprotein Metabolism Section, National Heart Lung and Blood Institute, Bethesda, MD, USA. 5. Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA. Electronic address: tsaix001@umn.edu.
Abstract
BACKGROUND: Discordant levels of apolipoprotein B (apo B) relative to low-density lipoprotein cholesterol (LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C) may be associated with subclinical atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: The present study investigated whether discordance between apo B and LDL-C or non-HDL-C levels was associated with subclinical ASCVD measured by coronary artery calcium (CAC). METHODS: This study was conducted in a subpopulation of the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, aged 45 to 84 years, free of ASCVD, and not taking lipid-lowering medications at the baseline (2000-2002) (prevalence analytic N = 4623; incidence analytic N = 2216; progression analytic N = 3947). Apo B discordance relative to LDL-C and non-HDL-C was defined using residuals and percentile rankings (>5/10/15 percentile). Associations with prevalent and incident CAC (CAC > 0 vs CAC = 0) were assessed using prevalence ratio/relative risk regression and CAC progression (absolute increase/year) using multinomial logistic regression. RESULTS: Higher apo B levels were associated with CAC prevalence, incidence, and progression. Apo B discordance relative to LDL-C or non-HDL-C was inconsistently associated with CAC prevalence and progression. Discordantly high apo B relative to LDL-C and non-HDL-C was associated with CAC progression. Associations for apo B discordance with non-HDL-C remained after further adjustment for metabolic syndrome components. CONCLUSION: Apo B was associated with CAC among adults aged ≥45 years not taking statins, but provided only modest additional predictive value of apo B for CAC prevalence, incidence, or progression beyond LDL-C or non-HDL-C. Apo B discordance may still be important for ASCVD risk assessment and further research is needed to confirm findings.
BACKGROUND: Discordant levels of apolipoprotein B (apo B) relative to low-density lipoprotein cholesterol (LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C) may be associated with subclinical atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: The present study investigated whether discordance between apo B and LDL-C or non-HDL-C levels was associated with subclinical ASCVD measured by coronary artery calcium (CAC). METHODS: This study was conducted in a subpopulation of the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, aged 45 to 84 years, free of ASCVD, and not taking lipid-lowering medications at the baseline (2000-2002) (prevalence analytic N = 4623; incidence analytic N = 2216; progression analytic N = 3947). Apo B discordance relative to LDL-C and non-HDL-C was defined using residuals and percentile rankings (>5/10/15 percentile). Associations with prevalent and incident CAC (CAC > 0 vs CAC = 0) were assessed using prevalence ratio/relative risk regression and CAC progression (absolute increase/year) using multinomial logistic regression. RESULTS: Higher apo B levels were associated with CAC prevalence, incidence, and progression. Apo B discordance relative to LDL-C or non-HDL-C was inconsistently associated with CAC prevalence and progression. Discordantly high apo B relative to LDL-C and non-HDL-C was associated with CAC progression. Associations for apo B discordance with non-HDL-C remained after further adjustment for metabolic syndrome components. CONCLUSION: Apo B was associated with CAC among adults aged ≥45 years not taking statins, but provided only modest additional predictive value of apo B for CAC prevalence, incidence, or progression beyond LDL-C or non-HDL-C. Apo B discordance may still be important for ASCVD risk assessment and further research is needed to confirm findings.
Authors: Michael J Pencina; Ralph B D'Agostino; Tomasz Zdrojewski; Ken Williams; George Thanassoulis; Curt D Furberg; Eric D Peterson; Ramachandran S Vasan; Allan D Sniderman Journal: Eur J Prev Cardiol Date: 2015-01-29 Impact factor: 7.804
Authors: Diane E Bild; Robert Detrano; Do Peterson; Alan Guerci; Kiang Liu; Eyal Shahar; Pamela Ouyang; Sharon Jackson; Mohammed F Saad Journal: Circulation Date: 2005-03-15 Impact factor: 29.690
Authors: Richard A Kronmal; Robyn L McClelland; Robert Detrano; Steven Shea; João A Lima; Mary Cushman; Diane E Bild; Gregory L Burke Journal: Circulation Date: 2007-05-14 Impact factor: 29.690
Authors: H M Krumholz; T E Seeman; S S Merrill; C F Mendes de Leon; V Vaccarino; D I Silverman; R Tsukahara; A M Ostfeld; L F Berkman Journal: JAMA Date: 1994-11-02 Impact factor: 56.272
Authors: Brian T Steffen; Weihua Guan; Alan T Remaley; Pathmaja Paramsothy; Susan R Heckbert; Robyn L McClelland; Philip Greenland; Erin D Michos; Michael Y Tsai Journal: Arterioscler Thromb Vasc Biol Date: 2014-12-04 Impact factor: 8.311
Authors: Alexander C Razavi; Lydia A Bazzano; Jiang He; Marie Krousel-Wood; Kirsten S Dorans; Michael A Razavi; Camilo Fernandez; Seamus P Whelton; Tanika N Kelly Journal: Am J Prev Cardiol Date: 2021-05-04
Authors: Anastasia Gurinovich; Zeyuan Song; William Zhang; Anthony Federico; Stefano Monti; Stacy L Andersen; Lori L Jennings; David J Glass; Nir Barzilai; Sofiya Millman; Thomas T Perls; Paola Sebastiani Journal: Geroscience Date: 2021-05-04 Impact factor: 7.581
Authors: Nicholas Felici; Da Liu; Josh Maret; Mariana Restrepo; Yuliya Borovskiy; Jihane Hajj; Wesley Chung; Krzysztof Laudanski Journal: Front Cardiovasc Med Date: 2021-11-15
Authors: Emil Hagström; P Gabriel Steg; Michael Szarek; Deepak L Bhatt; Vera A Bittner; Nicolas Danchin; Rafael Diaz; Shaun G Goodman; Robert A Harrington; J Wouter Jukema; Evangelos Liberopoulos; Nikolaus Marx; Jennifer McGinniss; Garen Manvelian; Robert Pordy; Michel Scemama; Harvey D White; Andreas M Zeiher; Gregory G Schwartz Journal: Circulation Date: 2022-06-30 Impact factor: 39.918