Residual cardiovascular risk is tracked by apolipoprotein B in coronary patients with elevated serum triglyceride levels: the ESC EORP EUROASPIRE IV survey

Abstract

Background and aims: Based on data from the EUROASPIRE IV survey, we aimed at assessing the possible residual risk tracked by serum apolipoprotein B in coronary patients with elevated serum triglycerides.

Methods: All samples from the total EUROASPIRE IV survey (n = 7998) with low serum total cholesterol (<4.5 mmol/L) and high serum triglycerides (≥1.7 mmol/L) were used to analyse apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) concentrations (n = 938). We selected a similar number of participants (n = 938) with low total cholesterol and with low triglycerides (<1.0 mmol/L). In addition, phospholipid transfer protein (PLTP) and cholesteryl ester transfer protein (CETP) as well as paraoxonase-1 (PON-1), angiopoietin-like (ANGPTL)-3 and ANGPTL-8 were analysed in randomly selected participants.

Results: Despite the lower low-density lipoprotein cholesterol (LDL-C) concentration in the patients with TG ≥ 1.7 mmol/L (1.89 ± 0.44 mmol/L) than those with TG < 1.0 mmol/L (1.99 ± 0.43 mmol/L), p < 0.0001), serum total cholesterol, apoB, and HbA1c were all significantly (p < 0.0001) higher in patients with TG ≥ 1.7 mmol/L. In addition, high-density lipoprotein cholesterol (HDL-C), apoA-I, and CETP activity were significantly lower (p < 0.001) in these patients. The prevalence of obesity and diabetes was higher in the participants with TG ≥ 1.7 mmol/L than in those with TG < 1.0 mmol/L (52.6 % vs 21.9 % and 41.3 % vs. 20.0 %).

Conclusions: Statin treatment is mainly decreasing serum LDL-C concentration, but apoB measurements with excess serum triglycerides carried by apoB-containing lipoproteins could provide more specific information about the risk assessment of cardiovascular disease in atherogenic dyslipidemia.

Keywords: Apolipoprotein B; Cardiovascular disease; LDL-C; Triglycerides.