👤 Mahmoud Torkamani

When Apolipoprotein B (ApoB) is discordant with either LDL cholesterol (LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C), ApoB is a stronger predictor of atherosclerotic cardiovascular disease (ASCVD). It is unclear whether ApoB also provides better risk stratification when ApoB and LDL particle number (LDL-P) are discordant. Here we examine the relationship between ApoB and LDL-P in the UK Biobank to determine which biomarker provides more accurate risk prediction when ApoB and LDL-P are discordant. The UK Biobank is a prospective observational study of 500,000 adults. Analyses were restricted to 41,099 participants (mean age 57 years, 49.7% female, 95.1% white) with at least 10 years of data following enrollment, three or more recorded ICD codes, plasma lipoprotein and apolipoprotein measurements, and available baseline characteristics. Major adverse cardiovascular events (MACE) and coronary artery disease (CAD) events were plotted against LDL-P and ApoB for all participants. Concordance was defined as the linear regression line with y-intercept forced to zero. Discordant subpopulations were defined as populations 2, 4, 6, 8, 10, 20, and 30% above or below the regression line. The hazard ratio (HR) of cases to controls was determined for the discordant subpopulations and the concordant control group. A HR>1 means that the risk is greater in the discordant group than the reference group, whereas a HR<1 suggests that the cases are less common in the discordant group. Over 10 years of follow-up, 9,663 MACE and 1,754 CAD events occurred. There was no significant increase in HR for CAD events or MACE for the subpopulations with discordant LDL-P vs ApoB. In contrast, among subpopulations with discordant ApoB, the HR for both MACE and CAD events increased as discordance increased and was statistically significant at all percentage discordance cutoffs. At only 2% ApoB discordance, HRs were already elevated for both MACE (HR 1.1, P<0.0001) and CAD (HR 1.1, P<0.0001). Risk increased progressively, reaching HR 1.4 for MACE and HR 2.5 for CAD at 30% discordance. This study suggests that ApoB is a more accurate marker for cardiovascular risk than LDL-P when discordant, as marked by ApoB levels in excess of LDL-P. Notably, risk was already elevated at as little as 2% discordance, suggesting that even modest mismatches between ApoB and LDL-P may be clinically relevant. In keeping with prior data examining discordance between ApoB and LDL-C or non-HDL-C, this data reinforces the utility of ApoB in guiding lipid-lowering strategies and cardiovascular risk assessment. Show less

Congestive heart failure is a complex multifactorial syndrome due to tissue hypoperfusion that is affected by some factors like inflammatory cytokines. In our study, we investigated the exact gene expression of three inflammatory cytokines in ischemic and idiopathic cardiomyopathy patients. From 49 studied recipients in the ischemic group, 23 (46.9%) were male and from 40 studied recipients in the idiopathic dilated cardiomyopathy group, 19 (47.5%) were male. For the quantitative analysis of interleukin (IL)-1, IL-27, and tumor necrosis factor (TNF)-α messenger RNAs expression level, the SYBR Green real-time polymerase chain reaction method was performed using SYBRPremix Ex TaqTM II (Tli RNaseH Plus; Takara) and designed primers specific for each gene in an iQ5 thermocycler (BioRad Laboratories) according to the manufacturer's instructions. Our results showed that the expression level of IL-1 and TNF-α were significantly higher in the ischemic patients compared to healthy controls ( Although we would introduce IL-1, IL-27, and TNF-α as effective inflammatory cytokines on myocardial functions in ischemic and idiopathic cardiomyopathy patients, there is not any difference between these two groups in gene expression of three main inflammatory cytokines. Show less