Apolipoprotein A-I and B concentrations were measured in
502 patients undergoing diagnostic cardiac catheterization to
assess the predictive power of apolipoproteins B and A-I to
discriminate between patients with coronary artery disease and
those with normal coronary arteries as defined by coronary arteriography. The strength of the associations was compared with
that of the associations between traditional risk factors (eg,
smoking status, cholesterol levels) and coronary artery disease.
The study population consisted of 154 women (mean age, 62.9
years) and 348 men (mean age, 59.6 years). The apolipoprotein A-I concentration averaged (± SD) 124 ± 25 mg/dL and the apolipoprotein B concentration, 98 ± 24 mg/dL. In all cases, the apolipoprotein measures showed a larger univariate difference between
the "normal" (no coronary artery disease) group (66 patients) and
the group with coronary artery disease (436 patients) than did the
corresponding standard lipoprotein measures. The variable with
the strongest association with coronary artery disease was the
ratio of apolipoprotein A-I to apolipoprotein B, followed by apolipoprotein B level. These findings were confirmed using logistic
regression, adjusting for other coronary artery disease risk factors. Fasting status did not affect apolipoprotein A-I or B concentrations. We conclude that the use of apolipoprotein A-I and B
concentrations gives additional information to that supplied by
lipoprotein measures to help predict the presence of coronary
artery disease. Since traditional lipid measures may be changed
by a meal, apolipoproteins A-I and B might be more useful measures when the fasting status of a patient is in question.
(Arch Intern Med. 1990;150:1629-1633)
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