Combination of hs-CRP, apoB/A-I ratio useful for predicting coronary artery disease
MedWire News: A combination of high-sensitivity C-reactive protein (hs-CRP) and apolipoprotein (apo)B/A-I ratio should be assessed prior to elective coronary angiography (CAG) in patients with suspected coronary artery disease (CAD), say researchers.
Zhu-Zhi Wen (Sun Yat-Sen University, Guangzhou, China) and co-authors explain that performing CAG in all patients with suspected CAD is not cost-effective. Therefore, "adjunctive markers are needed to stratify individuals who will merit a coronary angiogram."
Both hs-CRP and the apoB/A-I ratio have been considered as "promising factors" for predicting cardiovascular disease (CVD), independent of other CVD risk factors.
Wen et al therefore investigated the predictive value of the combination of these factors for the outcomes of CAG and echocardiography in 1757 patients admitted to a cardiology department between March 2008 and November 2010. Selective CAG was performed in 814 of these patients with suspected CAD.
Overall, 614 patients were diagnosed with CAD, the prevalence of which was significantly higher in patients with high levels of hs-CRP (>3 mg/L) and apoB/A-I ratio (>0.9 in men and >0.8 in women) than those with lower levels of hs-CRP and apoB/A-I ratio, at 42.1% versus 30.8%, respectively.
High levels of hs-CRP and apoB/A-I ratio were also significantly associated with the presence and severity of angiographic profiles and the levels of left ventricular (LV) ejection fraction, LV mass, and LV mass index, reports the team in the journal Clinical Biochemistry.
Furthermore, the proportion of patients with presence of coronary stenosis (nonstenosis, stenosis <50%, and ≥50% stenosis) and the number of significant stenosis vessels (stenosis ≥50%) was significantly higher among patients with high hs-CRP levels and apoB/A-I ratio compared with those with lower levels.
Of note, the combination of hs-CRP and apoB/A-I was shown to be an independent predictor for CAD in patients who underwent elective angiography, write the authors.
They speculate that "the high levels of hs-CRP and apoB/A-I ratio in combination are better than the high levels of hs-CRP or apoB/A-I ratio alone in predicting CAD in patients undergoing elective CAG."
However, "further prospective research with larger populations in multi-center and more diverse population is required to provide adequate evidence whether hs-CRP and the apoB/A-I ratio should be extensively applied as predictive biomarkers in clinical cardiology patients in future," concludes the team.
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By Nikki Withers