THE ASSOCIATION BETWEEN ApoB, LDLc, NON HDLc LEVELS AND CORONARY ARTERY LESIONS AND STATIN TREATMENT OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROME
Main Article Content
Abstract
Background: Acute coronary syndrome (ACS) is a serious cardiovascular event in which dyslipidemia, particularly ApoB, LDL-C, and non-HDL-C, plays an important role. Besides LDL-C, ApoB and non-HDL-C may better reflect the burden of atherogenic lipoproteins; however, their associations with the severity of coronary artery lesions and response to statin therapy remain unclear. Objectives: 1. To investigate the levels and associations of ApoB, LDLc, and Non HDLc in patients with acute coronary syndrome; 2. To examine the relationship between ApoB, LDLc, and Non HDLc levels and the severity of coronary artery lesions; 3. To evaluate changes in ApoB, LDLc, and Non HDLc levels after statin therapy in patients with acute coronary syndrome. Materials and methods: A cross-sectional analytical study was conducted in patients diagnosed with acute coronary syndrome who underwent percutaneous coronary angiography at the hospital. The severity of coronary artery lesions was assessed using the Gensini score. ApoB, LDLc, and Non HDLc levels were measured before and after treatment with highintensity statins according to standard protocols. Correlation analysis and multivariate regression were performed to determine the independent associations between lipid parameters, the severity of coronary lesions, and treatment response. Results: ApoB, LDLc, and Non HDLc levels were strongly positively correlated with each other (p < 0.001). However, ApoB, LDLc, and Non HDLc levels showed a weak inverse correlation with the severity of coronary artery lesions (p < 0.05). After statin therapy, changes in lipid parameters were strongly and positively correlated with each other with statistical significance (p < 0.001). Conclusions: ApoB, LDLc, and Non HDLc levels are elevated in patients with acute coronary syndrome. ApoB shows a strong positive correlation with LDLc and Non HDLc. Statin therapy demonstrates effective lipid reduction, with these parameters changing in a closely correlated manner. However, ApoB does not fully reflect the severity of coronary artery lesions. The positive correlation in treatment-induced changes with statins is very strong. Nevertheless, the magnitude of reduction in ApoB and LDLc differs under statin therapy. In light of recent breakthrough studies highlighting the prognostic role of ApoB in predicting cardiovascular events, ApoB is expected to become a complementary tool contributing to the optimal management of patients with acute coronary syndrome.
Keywords
ApoB, LDLc, Non HDLc, coronary artery lesions, statin
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
2. Daniel Eric Soffer, Nicholas A. Marston, et al. Role of apolipoprotein B in the clinical management of cardiovascular risk in adults: An Expert Clinical Consensus from the National Lipid Association. Journal of Clinical Lipidology. 2024. 18(5), E647-E663, doi: 10.1016/j.jacl.2024.08.013.
3. Robert A. Byrne, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. European Heart Journal. 2023. 44, 1720-3826, doi: 10.1093/eurheartj/ehad191.
4. Delpiana Siallagan, Jelita Siregar, Refli Hasan. Correlation between Apolipoprotein B Levels with Coronary Lesion Area Based on the Gensini Scores in Coronary Heart Disease Patients. Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI). 2023. 5(3), 135-144, DOI:10.32734/jetromi.v5i3.14396.
5. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983. 51(3), 606, doi: 10.1016/s0002-9149(83)80105-2.
6. Lê Kiều My, Nguyễn Văn Tân, Lê Đình Thanh. Nghiên cứu mối liên quan giữa Apolipoprotein B đến kết cục lâm sàng nội viện trên bệnh nhân cao tuổi hội chứng vành cấp. Tạp chí y học Việt Nam. 2025. 3, 345-350, DOI: 10.51298/vmj.v552i3.15156.
7. Trần Nguyễn Phương Hải, Phan Thị Hoàng Yến, et al. Khảo sát nồng độ Apolipoprotein B ở bệnh nhân hội chứng vành cấp. Tạp chí y học Việt Nam. 2025. 3, 223-227.
8. Huynh Thuc Bao, Doan Chi Thang, Ho Anh Binh, Mai Xuan Anh. Studying variable in serum apolipoprotein B levels in damaged coronary artery patients. Tạp Chí Y học lâm sàng Bệnh viện Trung Ương Huế. 2023. 86, 90–97, DOI:10.38103/jcmhch.86.14.
9. Allan D Sniderman, Line Dufresne, Karol M Pencina, Selin Bilgic, George Thanassoulis, Michael J Pencina. Discordance among apoB, non–high-density lipoprotein cholesterol, and triglycerides: Implications for cardiovascular prevention. European Heart Journal. 2024. 45(27), 2410–2418, doi: 10.1093/eurheartj/ehae25.