Apolipoprotein B and Coronary Artery Disease in Women

A Cross-sectional Study in Women Undergoing Their First Coronary Angiography

From the Department of Internal Medicine, University Hospital Utrecht, Utrecht (H.T.W., D.W.E.); the Department of Cardiology, Oosterschelde Hospital Goes, Goes (J.E.R. van L., H.W.O.R. van L., A.-H.L., J.A.J. de B.); and the Julius Center for Patient-Oriented Research, University Hospital Utrecht, Utrecht (Y.T. van der S.), the Netherlands.

Correspondence to H.E. Westerveld, MD, University Hospital Utrecht, G02.228 Heidelberglaan 100, 3584 CX Utrecht, PO Box 85.500, 3508 GA Utrecht, Netherlands. E-mail h.e.westerveld{at}digd.azu.nl

Abstract—The association between plasma apolipoprotein (apo) B concentrations and angiographically determined coronary artery disease (CAD) was investigated in women in a cross-sectional study. Stenosis of >60% in 1 or more coronary arteries was classified as CAD+. CAD- was defined as a maximum stenosis of 10% in any coronary artery. Fasting plasma concentrations of apoB, apoA-I, cholesterol (chol), low density lipoprotein cholesterol (LDL-chol), high density lipoprotein cholesterol (HDL-chol), and triglycerides (TGs) were determined. Information on nonlipid risk factors was obtained from questionnaires. CAD+ women (n=160) were older than CAD- women (n=129), 64.0±7.8 vs 57.8±11.1 years, respectively. CAD+ compared with CAD- women had higher frequencies of diabetes (14.7% vs 5.8%, P=0.05), hypertension (53% vs 37%, P=0.018), and ever-smoking (48% vs 35%, P<0.001). CAD+ women had higher plasma concentrations of apoB (1.48±0.32 vs 1.25±0.34 g/L, P<0.001), chol (7.01±1.19 vs 6.38±1.22 mmol/L, P=0.001), LDL-chol (4.74±1.09 vs 4.13±1.13 mmol/L, P<0.001), and TGs (1.98±0.84 vs 1.71±0.93 mmol/L, P=0.007) and lower levels of HDL-chol (1.28±0.28 vs 1.37±1.38 mmol/L, P=0.028). After correction for nonlipid risk factors, apoB, chol, LDL-chol, HDL-chol, and TG were independently related to CAD. In the lowest quartiles of chol, LDL-chol, and TG, CAD+ women had higher apoB concentrations than CAD- women. In contrast, chol, LDL-chol, TG, or HDL-chol levels were not different in any quartile of apoB. ApoB showed the most significant relation with the number of stenotic vessels, and apoB was associated with CAD in the normolipidemic subgroup. In conclusion, apoB was superior to chol, LDL-chol, HDL-chol, TG, and apoA-I in discriminating between CAD+ and CAD-.

Key Words: apolipoprotein B • coronary artery disease • coronary angiography • women

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				References Circulation, December 17, 2002; 106(25): 3373 - 3421. [Full Text]

				J. E Roeters van Lennep, H.T. Westerveld, D.W. Erkelens, and E. E van der Wall Risk factors for coronary heart disease: implications of gender Cardiovasc Res, February 15, 2002; 53(3): 538 - 549. [Abstract] [Full Text] [PDF]

				E. T.P. Keulen, M. Kruijshoop, N. C. Schaper, A. P.G. Hoeks, and T. W.A. de Bruin Increased Intima-Media Thickness in Familial Combined Hyperlipidemia Associated With Apolipoprotein B Arterioscler Thromb Vasc Biol, February 1, 2002; 22(2): 283 - 288. [Abstract] [Full Text] [PDF]

				J. E. R. van Lennep, H. T. Westerveld, H. W. O. R. van Lennep, A. H. Zwinderman, D. W. Erkelens, and E. E. van der Wall Apolipoprotein Concentrations During Treatment and Recurrent Coronary Artery Disease Events Arterioscler Thromb Vasc Biol, November 1, 2000; 20(11): 2408 - 2413. [Abstract] [Full Text] [PDF]

				A. M. Wagner, J. L. Sanchez-Quesada, A. Perez, M. Rigla, M. Cortes, F. Blanco-Vaca, and J. Ordonez-Llanos Inaccuracy of Calculated LDL-Cholesterol in Type 2 Diabetes: Consequences for Patient Risk Classification and Therapeutic Decisions Clin. Chem., November 1, 2000; 46(11): 1830 - 1832. [Full Text] [PDF]

				J.E Roeters van Lennep, A.H Zwinderman, H.W.O Roeters van Lennep, H.E Westerveld, H.W.M Plokker, A.A Voors, A.V.G Bruschke, and E.E van der Wall Gender differences in diagnosis and treatment of coronary artery disease from 1981 to 1997. No evidence for the Yentl syndrome Eur. Heart J., June 1, 2000; 21(11): 911 - 918. [Abstract] [PDF]

				A. J. Moss, R. E. Goldstein, V. J. Marder, C. E. Sparks, D. Oakes, H. Greenberg, H. J. Weiss, W. Zareba, M. W. Brown, C.-S. Liang, et al. Thrombogenic Factors and Recurrent Coronary Events Circulation, May 18, 1999; 99(19): 2517 - 2522. [Abstract] [Full Text] [PDF]