Recently, a study has been conducted by the researchers of the Karolinska Institute in Stockholm, Sweden to investigate the link between apoB/apoA-1 ratios of lipids and incidence of nonfatal heart attacks, strokes, and cardiovascular mortality (MACEs).
As per World Health Organization (WHO), Cardiovascular diseases are a group of disorders of the heart and blood vessels. "An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke."
Meanwhile, FACC, FAHA, FACP, Katz Professor in preventive cardiology and founder of the Emory Center for Heart Disease Prevention at Emory University, GA, Dr. Laurence Sperling said, “ApoB and apoB/apoA are not new markers."
As quoted by Medical Health News, Dr. Rigved Tadwalkar explained, "the medical community has long relied upon the use of traditional markers, such as LDL-C and HDL-C to determine the risk for incident cardiovascular disease.”
Data Analysis
For the study, the data was gathered from the AMORIS cohort. AMORIS cohort is a database which contains the health records from individuals including blood and urine sample analyses in Sweden between 1985–1996.
The data was analyzed from participants who were either healthy and underwent routine yearly health checkups or outpatients referred for lab tests.
To analyze the data, samples from 137,100 individual participants have been collected which included both men and women who have attained the age group of 25–84 years without a history of MACE, coronary artery bypass grafting, or percutaneous coronary intervention, which is a minimally-invasive procedure that aims to unblock clogged coronary arteries.
The analysis was carried forward on the basis of participant's history in apoB levels, apoA-1 levels, total cholesterol, triglycerides, serum glucose. However, there was a limited information available on cardiovascular risk factors, including tobacco smoking and hypertension.
- It has been noted that "average follow-up times were 17.8 years for the entire 30-year study period. During this time, there had been 22,473 MACEs, including 8,567 nonfatal heart attacks, 8,194 nonfatal strokes, and 5,712 cardiovascular deaths", said the study analysis.
- It has been found that the higher the apoB level and the lower the apoA-1 levels were, the greater the cardiovascular risk among both men and women.
- Individuals with high apoB/apoA-1 values were three times more likely to have a heart attack as compared to those who have low values.
- Individuals with high lipid levels were also likely at nearly a 70% greater risk of a major cardiovascular event and almost 40% more likely to die from cardiovascular causes.
Conclusions
The findings of the analysis have concluded that scientists should agree on the cut-off values for apoB/apoA-1 ratios so that cardiovascular risk guidelines can include the measurement.
The researchers said, “If there is an imbalance between pro- and anti-atherogenic functions, defined by a high apoB/apoA-1 ratio, atherosclerosis speeds up with obstructions to blood flow, risk of thrombosis, embolization, or even rupture of blood vessels that may cause serious cardiovascular complications or fatal events as shown in our present study."
Medical Health News quoted Prof. Walldius and Prof. Hammar as saying, “Based on our long-term study […], we suggest that apoB, apoA-1, and especially the apoB/apoA-1 ratio, should be considered in future international guidelines for patients where the usual indicators of dyslipidemia are less effective for cardiovascular risk evaluation. Early detection and treatment of dyslipidemia may prevent severe cardiovascular disease and save lives.”