Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results


2008 | 3 | 4 | 422-429

Article title

The correlation of apolipoprotein B, apolipoprotein B/apolipoprotein A-I ratio and lipoprotein(a) with myocardial infarction


Title variants

Languages of publication



Recent evidence shows that apolipoprotein (apo) B, apoB/apoA-I ratio and lipoprotein(a) are better indicators of coronary risk than the conventional lipid profile. The aim of this study was to evaluate the correlation of apoA-I and B, and lipoprotein(a) with myocardial infarction (MI). We performed a cross-sectional study including 208 patients (100 men and 108 women), with and without previous MI evaluated by coronary angiography. The severity of coronary heart disease was scored on the basis of the number and extent of lesions in the coronary arteries. Lipid levels were measured by the enzymatic method and apolipoprotein levels were measured by the immunoturbidimetric method. The MI group had higher plasmatic levels of lipoprotein(a) (0.37±0.28 vs. 0.29±0.23 g/L, p<0.05), apoB (1.13±0.40 vs. 0.84±0.28 g/L, p<0.05) and of the apoB/apoA-I ratio (0.77±0.37 vs. 0.68±0.20, p<0.05) compared to controls. The area under the receiver operating characteristic (ROC) curves (AUC) suggested a good reliability in the diagnose of coronary heart disease for the apoB/apoA-I ratio (0.756, p<0.05), apoB (0.664, p<0.05), lipoprotein(a) (0.652, p<0.05) and total cholesterol/HDL-cholesterol (0.688, p<0.05). Multivariate analysis performed with adjustments for cardiovascular risk factors, showed that the levels of lipoprotein(a), apoB and apoB/apoA-I ratio are significant independent cardiovascular risk factors. Our results indicate that there is an important relationship among high plasma apoB concentration, lipoprotein(a) concentration, the apoB/apoA-I ratio, and MI. We showed that the apoB/apoA-I ratio has a stronger correlation with MI than the total cholesterol/HDL cholesterol ratio. We therefore suggest using apoB/apoA-I ratio and lipoprotein(a) in clinical practice as a markers of MI risk.










Physical description


1 - 12 - 2008
22 - 10 - 2008


  • Department of Medical Sciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006, Cluj-Napoca, Romania
  • Department of Normal Morphology and Functions, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006, Cluj-Napoca, Romania
  • Department of Internal Medicine, 77120, Coulommiers, France
  • Department of Medical Sciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006, Cluj-Napoca, Romania


  • [1] Grundy S.M., Becker D., Clark L.T., Cooper R.S., Denke M.A., Howard J., et al., Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), Circulation 2002, 106, 3143–3421 http://dx.doi.org/10.1161/01.CIR.0000038419.53000.D6[Crossref]
  • [2] De Backer G., Ambrosioni E., Borch-Johnsen K., Brotons C., Cifkova R., Dallongeville J., et al., European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice, Eur. Heart J., 2003, 24, 1601–1610 http://dx.doi.org/10.1016/S0195-668X(03)00347-6[Crossref]
  • [3] Grundy S.M., Cleeman J.I., Merz N.B., Brewer H.B., Clark L.T., Hunninghake B.D., et al., Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines, Circulation, 2004, 110, 227–293 http://dx.doi.org/10.1161/01.CIR.0000133317.49796.0E[Crossref]
  • [4] Lamarche B., Moorjani S., Lupien P.J., Cantin B., Bernard P.M., Dagenais G.R., et al., Apolipoprotein A-I and B levels and the risk of ischemic heart disease during a 5-year follow-up of men in the Quebec Cardiovascular Study, Circulation, 1996, 94, 273–278
  • [5] Vedhachalam C., Duong P.T., Nickel M., Nguyen D., Dhanasekaran P., Saito H., et al., Mechanism of ATP-binding cassette transporter A1-mediated cellular lipid efflux to apolipoprotein A-I and formation of high density lipoprotein particles, J. Biol. Chem., 2007, 282, 25123–25130 http://dx.doi.org/10.1074/jbc.M704590200[Crossref][WoS]
  • [6] Walldius G., Jungner I., Holme I., Aastveit A.H., Kolar W., Steiner E., High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study, Lancet, 2001, 358, 2026–2033 http://dx.doi.org/10.1016/S0140-6736(01)07098-2[Crossref]
  • [7] Walldius G., Jungner I., Aastveit A.H., Holme I., Furberg C.D., Sniderman A.D., The apoB/apoA-I ratio is better than the cholesterol ratios to estimate the balance between plasma proatherogenic and antiatherogenic lipoproteins and to predict coronary risk, Clin. Chem. Lab. Med., 2004, 42, 1355–1363 http://dx.doi.org/10.1515/CCLM.2004.254[Crossref]
  • [8] Yusuf S., Hawken S., Ôunpuu S., Dans T., Avezum A., Lanas F., et al., Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study, Lancet, 2004, 364, 937–952 http://dx.doi.org/10.1016/S0140-6736(04)17018-9[Crossref]
  • [9] van der Steeg W.A., Boekholdt S.M., Stein E.A., El-Harchaoui K., Stroes E.S.G., Sandhu M.S., et al., Role of the apolipoprotein B-apolipoprotein A-I ratio in cardiovascular risk assessment: A case-control analysis in EPIC-Norfolk, Ann. Intern. Med., 2007, 146, 640–648
  • [10] Berglund L., Ramakrishnan R., Lipoprotein(a): an elusive cardiovascular risk factor, Aterioscler. Thromb. Vasc. Biol., 2004, 24, 2219–2226 http://dx.doi.org/10.1161/01.ATV.0000144010.55563.63[Crossref]
  • [11] Hartmann M., von Birgelen C., Mintz G.S., Stoel M.G., Eggebrecht H., Wieneke H., et al., Relation between lipoprotein (a) and fibrinogen and serial intravascular ultrasound plaque progression in left main coronary arteries, J. Am. Coll. Cardiol., 2006, 48, 446–452 http://dx.doi.org/10.1016/j.jacc.2006.03.047[Crossref]
  • [12] Antman E.M., Anbe D.T., Armstrong P.W., Bates E.R., Green L.A., Hand M., et al., ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Circulation, 2004, 110, e82–292 http://dx.doi.org/10.1161/01.CIR.0000134791.68010.FA[Crossref]
  • [13] Gibbons R.J., Balady G.J., Bricker J.T., Chaitman B.R., Fletcher G.F., Froelicher V.F., et al., ACC/AHA 2002 guideline update for exercise testing: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, J. Am. Coll. Cardiol., 2002, 40, 1531–1540 http://dx.doi.org/10.1016/S0735-1097(02)02164-2[Crossref]
  • [14] Cheitlin M.D., Armstrong W.F., Aurigemma G.P., Beller G.A., Bierman F.Z., Davis J.L., et al., ACC/AHA/ASE guideline update for the clinical application of echocardiography: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, J. Am. Soc. Echocardiogr., 2003, 16, 1091–1110
  • [15] Smith S.C.Jr., Feldman T.E., Hirshfeld J.W.Jr., Jacobs A.K., Kern M.J., King S.B., et al., ACC/AHA/SCAI guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Circulation, 2006, 113, 156–175 http://dx.doi.org/10.1161/CIRCULATIONAHA.105.170815[Crossref]
  • [16] Silber S., Albertsson P., Aviles F.F., Camici P.G., Colombo A., Hamm C., et al., Guidelines for percutaneous coronary interventions. The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology, Eur. Heart J., 2005, 26, 804–847 http://dx.doi.org/10.1093/eurheartj/ehi564[Crossref]
  • [17] Marcovina S.M., Albers J.J., Henderson L.O., Hannon W.H., International Federation of Clinical Chemistry standardization project for measurements of apolipoproteins A-I and B. III. Comparability of apolipoprotein A-I values by use of international reference material, Clin. Chem., 1993, 39, 773–781
  • [18] Marcovina S.M., Albers J.J., Kennedy H., Mei J.V., Henderson L.O., Hannon W.H., International Federation of Clinical Chemistry standardization project for measurements of apolipoproteins A-I and B. IV. Comparability of apolipoprotein B values by use of International Reference Material, Clin. Chem., 1994, 40, 586–592
  • [19] Marcovina S.M., Albers J.J., Scanu A.M., Kennedy H., Giaculli F., Berg K., et al., Use of a reference material proposed by the International Federation of Clinical Chemistry and Laboratory Medicine to evaluate analytical methods for the determination of plasma lipoprotein(a), Clin. Chem., 2000, 46, 1956–1967
  • [20] Mancia G., Rosei E.A., Cifkova R., DeBacker G., Erdine S., Fagard R., et al., European Society of Hypertension-European Society of Cardiology. Guidelines for the management of arterial hypertension, J. Hypertens., 2003, 21, 1011–1053 http://dx.doi.org/10.1097/00004872-200306000-00001[Crossref]
  • [21] The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Follow-up report on the diagnosis of diabetes mellitus, Diabetes Care, 2003, 26, 3160–3167 http://dx.doi.org/10.2337/diacare.26.11.3160[Crossref]
  • [22] Poirier P., Giles T.D., Bray G.A., Hong Y., Stern Y.S., Pi-Sunyer F.X., et al., Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss an update of the 1997 American Heart Association Scientific statement on obesity and heart disease from the obesity committee of the council on nutrition, physical activity, and metabolism, Circulation, 2006, 113, 898–918 http://dx.doi.org/10.1161/CIRCULATIONAHA.106.171016[Crossref]
  • [23] Fawcett T., An introduction to ROC analysis, Pattern Recognition Letters, 2006, 27, 861–874 http://dx.doi.org/10.1016/j.patrec.2005.10.010[Crossref]
  • [24] Luc G., Bard J.M., Ferrieres J., Evans A., Amouyel P., Arveiler D., et al., Value of HDL cholesterol, apolipoprotein A-I, lipoprotein A-I, and lipoprotein A-I/A-II in prediction of coronary heart disease: the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction, Arterioscler. Thromb. Vasc. Biol., 2002, 22, 1155–1161 http://dx.doi.org/10.1161/01.ATV.0000022850.59845.E0[Crossref]
  • [25] Meisinger C., Loewel H., Mraz W., Koenig W., Prognostic value of apolipoprotein B and A-I in the prediction of myocardial infarction in middle-aged men and women: results from the MONICA/KORA Augsburg cohort study, Eur. Heart J., 2005, 26, 271–278 http://dx.doi.org/10.1093/eurheartj/ehi003[Crossref]
  • [26] Pedersen T.R., Faergeman O., Kastelein J.J.P., Olsson A.G., Tikkanen M.J., Holme I., et al., The Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) Study Group. High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial, J.A.M.A., 2005, 294, 2437–2445 http://dx.doi.org/10.1001/jama.294.19.2437[Crossref]
  • [27] van der Steeg W.A., Holme I., Boekholdt S.M., Larsen M.L., Lindahl C., Stroes E.S., et al., High-density lipoprotein cholesterol, high-density lipoprotein particle size, and apolipoprotein A-I: significance for cardiovascular risk: the IDEAL and EPIC-Norfolk studies, J. Am. Coll. Cardiol., 2008, 51, 634–642 http://dx.doi.org/10.1016/j.jacc.2007.09.060[Crossref][WoS]
  • [28] Holmer S.R., Hengstenberg C., Kraft H.G., Mayer B., Pöll M., Kürzinger S., et al., Association of polymorphisms of the apolipoprotein(a) gene with lipoprotein(a) levels and myocardial infarctio, Circulation, 2003, 107, 696–701 http://dx.doi.org/10.1161/01.CIR.0000048125.79640.77[Crossref]
  • [29] Myers G.L., Christenson R.H., Cushman M., Ballantyne C.M., Cooper G.R., Grundy S.M., et al., National academy of clinical biochemistry laboratory medicine practice guidelines. Emerging biomarkers of cardiovascular disease and stroke, Clin. Chim. Lab. Med., 2007, 53, 552–574
  • [30] Luc G., Bard J.M., Arveiler D., Ferrieres J., Evans A., Amouyel P., et al., Lipoprotein (a) as a predictor of coronary heart disease: the PRIME Study, Atherosclerosis, 2002, 163, 377–384 http://dx.doi.org/10.1016/S0021-9150(02)00026-6[Crossref]
  • [31] von Eckardstein A., Schulte H., Cullen P., Assmann G., Lipoprotein(a) further increases the risk of coronary events in men with high global cardiovascular risk, J. Am. Coll. Cardiol., 2001, 37, 434–439 http://dx.doi.org/10.1016/S0735-1097(00)01126-8[Crossref]
  • [32] Thompson A., Danesh J., Associations between apolipoprotein B, apolipoprotein A-I, the apolipoprotein B/A-I ratio and coronary heart disease: a literature-based meta-analysis of prospective studies, J. Intern Med., 2006, 259, 481–492 http://dx.doi.org/10.1111/j.1365-2796.2006.01644.x[Crossref]
  • [33] Sniderman A.D., St Pierre A.C., Cantin B., Dagenais G.R., Despres J.P., Lamarche B., Concordance / discordance between plasma apolipoprotein B levers and the cholesterol indexes of atherosclerotic risk, Am. J. Cardiol., 2003, 91, 1173–1177 http://dx.doi.org/10.1016/S0002-9149(03)00262-5[Crossref]
  • [34] Walldius G., Jungner I., The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy-a review of the evidence, J. Intern Med., 2006, 259, 493–519 http://dx.doi.org/10.1111/j.1365-2796.2006.01643.x[Crossref]
  • [35] Gotto A.M.Jr., Whitney E., Stein E.A., Shapiro D.R., Clearfield M., Weis S., et al., Relation between baseline and on treatment lipid parameters and first acute major coronary events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS), Circulation, 2000, 101, 477–484
  • [36] Barter P.J., Ballantyne C.M., Carmena R., Castro Cabezas M., Chapman M.J., Couture P., et al., ApoB versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirty-person/ten-country panel, J. Intern Med., 2006, 259, 247–258 http://dx.doi.org/10.1111/j.1365-2796.2006.01616.x[Crossref]

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.