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Apolipoprotein proteomics for residual lipid-related risk in coronary heart disease

Abstract:

Background: Recognition of the importance of conventional lipid measures and the advent of novel lipid-lowering medications have prompted the need for more comprehensive lipid panels to guide use of emerging treatments for the prevention of coronary heart disease (CHD). This report assessed the relevance of 13 apolipoproteins measured using a single mass-spectrometry assay for risk of CHD in the PROCARDIS case-control study of CHD (941 cases/975 controls).

Methods: The associations of apolipoproteins with CHD were assessed after adjustment for established risk factors and correction for statin use. Apolipoproteins were grouped into 4 lipid-related classes [lipoprotein(a), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides] and their associations with CHD were adjusted for established CHD risk factors and conventional lipids. Analyses of these apolipoproteins in a subset of the ASCOT trial (Anglo-Scandinavian Cardiac Outcomes Trial) were used to assess their within-person variability and to estimate a correction for statin use. The findings in the PROCARDIS study were compared with those for incident cardiovascular disease in the Bruneck prospective study (n=688), including new measurements of Apo(a).

Results: Triglyceride-carrying apolipoproteins (ApoC1, ApoC3, and ApoE) were most strongly associated with the risk of CHD (2- to 3-fold higher odds ratios for top versus bottom quintile) independent of conventional lipid measures. Likewise, ApoB was independently associated with a 2-fold higher odds ratios of CHD. Lipoprotein(a) was measured using peptides from the Apo(a)-kringle repeat and Apo(a)-constant regions, but neither of these associations differed from the association with conventionally measured lipoprotein(a). Among HDL-related apolipoproteins, ApoA4 and ApoM were inversely related to CHD, independent of conventional lipid measures. The disease associations with all apolipoproteins were directionally consistent in the PROCARDIS and Bruneck studies, with the exception of ApoM.

Conclusions: Apolipoproteins were associated with CHD independent of conventional risk factors and lipids, suggesting apolipoproteins could help to identify patients with residual lipid-related risk and guide personalized approaches to CHD risk reduction.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1161/CIRCRESAHA.122.321690

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Research group:
Clinical Trial Service Unit and Epidemiological Studies Unit
Role:
Author
ORCID:
0000-0002-9183-2253
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Research group:
Clinical Trial Service Unit and Epidemiological Studies Unit
Role:
Author
ORCID:
0000-0003-0000-5664
More by this author
Role:
Author
ORCID:
0000-0001-7565-1455
More by this author
Role:
Author
ORCID:
0000-0002-5172-0935
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Research group:
Clinical Trial Service Unit and Epidemiological Studies Unit
Role:
Author
ORCID:
0000-0002-3861-6105

Contributors

Role:
Contributor


Publisher:
American Heart Association
Journal:
Circulation Research More from this journal
Volume:
132
Issue:
4
Pages:
452–464
Publication date:
2023-01-24
Acceptance date:
2023-01-10
DOI:
EISSN:
1524-4571
ISSN:
0009-7330


Language:
English
Keywords:
Pubs id:
1325239
Local pid:
pubs:1325239
Deposit date:
2023-02-01
ARK identifier:

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