The Predictive Value Of Serum Prebeta-1 High Density Lipoprotein On The Prognosis Of Patients With Coronary Heart Disease

Background With the advancement of world population aging, the incidence of coronary heart disease(CHD) also showed an increasing trend. A large number of epidemiological studies and trials had shown that high-level high density lipoprotein(HDL) can reduce the risk of cardiovascular disease. HDL may exert antiatherosclerotic activities by reverse cholesterol transport(RCT). Prebeta-1 high density lipoprotein(preβ1-HDL), a small discoid-shaped molecule, is a quantitatively minor species of HDL that migrates with preβ mobility in agrose gel electrophoresis. As the primary receptor of cholesterol efflux from atherosclerotic plaque mediated by ATP-binding cassette transporter A1(ABCA1), preβ1-HDL plays an important role in RCT. The concentration of prebeta-1 HDL not only reflected the output efficiency of cholesterol, but also related with coronary heart disease and its risk. However,there were no relevant literature about the relationship between preβ1-HDL and the prognosis of patients with coronary heart disease in China.Objective To investigate the predictive value of serum preβ1-HDL on the endpoint events in patients with CHD by prospective follow-up study.Methods The study consisted of patients with a complaint of angina pectoris who underwent coronary artery angiography in our hospital from 2008 to 2009. The concentration of serum preβ1-HDL was measured by sandwiched enzyme-linked sandwich immunoassay(ELISA). Patients were followed up every 6 months from the day of discharge. Patients were divided into two groups according to the median of serum preβ1-HDL level(23.36 mg/l). The incidence of primary and secondary end point events was compared. Cox regression analysis models and Kaplan-Meier curves were used to analyze the association between serum preβ1-HDL and endpoint eventsResults 1. The primary endpoint events were higher in the preβ1-HDL>23.36mg/l group than in the preβ1-HDL≤23.36mg/l group. Specifically, the incidence of cardiovascular mortality was significantly higher in the preβ1-HDL>23.36mg/l group. There was no significant difference in secondary endpoint events between the two groups.2. After adjusting for age, gender, current smoking, hypertension, diabetes, regular medication and serum LDL-C,TG, TC, HDL-C, Apo A-I, Apo B, and having PCI in hospital in Cox proportional hazards models showed that increased preβ1-HDL level only had a predictive value for primary end point events(95%CI: 1.622-14.765, P=0.005). There was no association between increased preβ1-HDL level and the risk of secondary end point events and each individual endpoint events.3. Kaplan-Meier curves shows that the primary end point events were higher in the preβ1-HDL>23.36mg/l group than in the preβ1-HDL≤23.36mg/l group(P=0.001). Specifically, the incidence of cardiovascular mortality was significantly higher in the preβ1-HDL>23.36mg/l group.(P=0.010).Conclusion Increased preβ1-HDL level had a predictive value for primary endpoint events, especially for cardiovascular mortality.