Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study
Abstract Background Apolipoprotein CIII (apoCIII) is associated with triglyceride-rich lipoprotein metabolism and has emerged as independent marker for risk of cardiovascular disease. The objective was to test whether apoCIII is regulated postprandially and whether apoCIII concentrations in native a...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | http://link.springer.com/article/10.1186/s12944-020-01293-9 |
| _version_ | 1829100411109244928 |
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| author | Julius L. Katzmann Christian M. Werner Tatjana Stojakovic Winfried März Hubert Scharnagl Ulrich Laufs |
| author_facet | Julius L. Katzmann Christian M. Werner Tatjana Stojakovic Winfried März Hubert Scharnagl Ulrich Laufs |
| author_sort | Julius L. Katzmann |
| collection | DOAJ |
| description | Abstract Background Apolipoprotein CIII (apoCIII) is associated with triglyceride-rich lipoprotein metabolism and has emerged as independent marker for risk of cardiovascular disease. The objective was to test whether apoCIII is regulated postprandially and whether apoCIII concentrations in native and chylomicron-free serum predict future cardiovascular events in patients with stable coronary artery disease (CAD). Methods ApoCIII concentrations were measured in native and chylomicron-free serum in the fasting state and after a standardized oral fat load test in 195 patients with stable CAD. Clinical follow-up was 48 months. Chylomicron-free serum was prepared by ultracentrifugation (18,000 rpm, 3 h). The log-rank test and Cox regression analyses were used to investigate the association of apoCIII with recurrent cardiovascular events. Results Of the 195 patients included, 92 had a cardiovascular event, and 103 did not. 97% were treated with a statin. No significant changes in apoCIII concentration were observed after the oral fat load test. The apoCIII concentration was associated with event-free survival independent of conventional risk factors. This association reached statistical significance only for apoCIII concentration measured in chylomicron-free serum (hazard ratio [95% confidence interval] for apoCIII above the mean: postprandial: 1.67 (1.06–2.29), P = 0.028, fasting: 2.09 (1.32–3.32), P = 0.002), but not for apoCIII concentration measured in native serum (postprandial: 1.47 [0.89–2.43], P = 0.133, fasting: 1.56 [0.95–2.58], P = 0.081). The effects were independent of other risk factors. Conclusions ApoCIII concentrations in chylomicron-free serum are independently associated with event-free survival in patients with CAD both in fasting and postprandial state. This findings support considering apoCIII for risk assessment and attempting to test the hypothesis that lowering apoCIII reduces residual cardiovascular risk. Take home message Apolipoprotein CIII concentration measured in chylomicron-free serum predicts recurrent cardiovascular events in patients with stable coronary artery disease. Trial registration The trial which included the participants of this study was registered at https://clinicaltrials.gov ( NCT00628524 ) on March 5, 2008. |
| first_indexed | 2024-12-10T22:31:57Z |
| format | Article |
| id | doaj.art-1100e27ab1934648b675b506b1b0ebf0 |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-12-10T22:31:57Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
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| series | Lipids in Health and Disease |
| spelling | doaj.art-1100e27ab1934648b675b506b1b0ebf02022-12-22T01:31:01ZengBMCLipids in Health and Disease1476-511X2020-05-0119111010.1186/s12944-020-01293-9Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational studyJulius L. Katzmann0Christian M. Werner1Tatjana Stojakovic2Winfried März3Hubert Scharnagl4Ulrich Laufs5Klinik und Poliklinik für Kardiologie, Universitätsklinikum LeipzigKlinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des SaarlandesKlinisches Institut für Medizinische und Chemische Labordiagnostik, LKH Universitätsklinikum GrazKlinisches Institut für Medizinische und Chemische Labordiagnostik, Medizinische Universität GrazKlinisches Institut für Medizinische und Chemische Labordiagnostik, Medizinische Universität GrazKlinik und Poliklinik für Kardiologie, Universitätsklinikum LeipzigAbstract Background Apolipoprotein CIII (apoCIII) is associated with triglyceride-rich lipoprotein metabolism and has emerged as independent marker for risk of cardiovascular disease. The objective was to test whether apoCIII is regulated postprandially and whether apoCIII concentrations in native and chylomicron-free serum predict future cardiovascular events in patients with stable coronary artery disease (CAD). Methods ApoCIII concentrations were measured in native and chylomicron-free serum in the fasting state and after a standardized oral fat load test in 195 patients with stable CAD. Clinical follow-up was 48 months. Chylomicron-free serum was prepared by ultracentrifugation (18,000 rpm, 3 h). The log-rank test and Cox regression analyses were used to investigate the association of apoCIII with recurrent cardiovascular events. Results Of the 195 patients included, 92 had a cardiovascular event, and 103 did not. 97% were treated with a statin. No significant changes in apoCIII concentration were observed after the oral fat load test. The apoCIII concentration was associated with event-free survival independent of conventional risk factors. This association reached statistical significance only for apoCIII concentration measured in chylomicron-free serum (hazard ratio [95% confidence interval] for apoCIII above the mean: postprandial: 1.67 (1.06–2.29), P = 0.028, fasting: 2.09 (1.32–3.32), P = 0.002), but not for apoCIII concentration measured in native serum (postprandial: 1.47 [0.89–2.43], P = 0.133, fasting: 1.56 [0.95–2.58], P = 0.081). The effects were independent of other risk factors. Conclusions ApoCIII concentrations in chylomicron-free serum are independently associated with event-free survival in patients with CAD both in fasting and postprandial state. This findings support considering apoCIII for risk assessment and attempting to test the hypothesis that lowering apoCIII reduces residual cardiovascular risk. Take home message Apolipoprotein CIII concentration measured in chylomicron-free serum predicts recurrent cardiovascular events in patients with stable coronary artery disease. Trial registration The trial which included the participants of this study was registered at https://clinicaltrials.gov ( NCT00628524 ) on March 5, 2008.http://link.springer.com/article/10.1186/s12944-020-01293-9Apolipoprotein CIIIChylomicronCardiovascular diseaseCoronary artery diseaseRisk factorAntisense oligonucleotide |
| spellingShingle | Julius L. Katzmann Christian M. Werner Tatjana Stojakovic Winfried März Hubert Scharnagl Ulrich Laufs Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study Lipids in Health and Disease Apolipoprotein CIII Chylomicron Cardiovascular disease Coronary artery disease Risk factor Antisense oligonucleotide |
| title | Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study |
| title_full | Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study |
| title_fullStr | Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study |
| title_full_unstemmed | Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study |
| title_short | Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study |
| title_sort | apolipoprotein ciii predicts cardiovascular events in patients with coronary artery disease a prospective observational study |
| topic | Apolipoprotein CIII Chylomicron Cardiovascular disease Coronary artery disease Risk factor Antisense oligonucleotide |
| url | http://link.springer.com/article/10.1186/s12944-020-01293-9 |
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