The Ratio of High‐Density Lipoprotein Cholesterol to Apolipoprotein A‐I Predicts Myocardial Injury Following Elective Percutaneous Coronary Intervention

摘要

Background High-density lipoprotein (HDL) has cardioprotective properties. Each HDL particle has a few molecules of apolipoprotein A-I (apoA-I) and carries various amounts of cholesterol. The ratio of high-density lipoprotein cholesterol (HDL-C) to apoA-I may reflect mean HDL particle size. Hypothesis HDL-C/apoA-I ratio may provide more information than HDL-C and apoA-I in predicting myocardial injury following elective percutaneous coronary intervention (PCI). Methods We prospectively enrolled 2529 consecutive patients who underwent elective PCI and assessed the relationships of preprocedural HDL-C, apoA-I, and their ratio with peak cardiac troponin I (cTnI) within 24 hours after PCI. Results Neither HDL-C nor apoA-I levels showed significant association with postprocedural cTnI elevation, whereas HDL-C/apoA-I ratio was associated with postprocedural cTnI elevation above 3 up to 30?×?upper limit of normal (ULN), with the lowest risk in the middle quintile (all P values for quadratic term were 3?×?ULN for quintile 1 to 5 of HDL-C/apoA-I ratio were: 1 (reference), 0.81 (0.62-1.07), 0.57 (0.43-0.75), 0.65 (0.49-0.85), and 0.76 (0.58–1.01), respectively, and the adjusted odds ratios of postprocedural cTnI >30?×?ULN for quintile 1 to 5 of HDL-C/apoA-I ratio were: 1 (reference), 0.81 (0.49-1.361), 0.42 (0.23-0.77), 0.66 (0.38-1.14), and 0.82 (0.49-1.38), respectively. Conclusions There was a U-shaped association between HDL-C/apoA-I ratio and myocardial injury following PCI.