apoB/apoA–I ratio is related to femoral artery plaques and is predictive for future cardiovascular events in healthy men

Objectives The aim of the present study was to investigate the association between serum concentrations of apoB, apoA–I and the apoB/apoA–I ratio and future cardiovascular events in a group of healthy 58-year-old men during 6.6 years of follow-up. A further aim was to investigate the concentrations of apoB, apoA–I and the apoB/apoA–I ratio to the association of plaque occurrence in the carotid and femoral arteries. Background Previous studies have shown that the apoB/apoA–I ratio is an important cardiovascular risk factor, whereas the association between apoB/apoA–I ratio and presence of atherosclerotic plaques in the carotid and femoral arteries has been less investigated. Methods The carotid and femoral arteries were examined by high-resolution B-mode ultrasound in 391, 58-year-old men identified by screening in the city of Göteborg, Sweden. Assessment of plaque occurrence and measurement of apolipoproteins (apoA–I and apoB) was performed. Results Subjects with an apoB/apoA–I ratio ≥0.9 had a significantly increased risk to suffer a cardiovascular event during 6.6 years of follow-up (OR 3.07, 95% CI 1.22–7.71), while no difference in risk for cardiovascular events was observed for subjects with LDL cholesterol >3.4 mmol/L compared to subjects <3.4 mmol/L (OR 1.04, 95% CI 0.37–2.46). A greater risk for plaques in the femoral artery was also observed in subjects with an apoB/apoA–I ratio ≥0.9 compared to subjects <0.9 (OR 3.06, 95% CI 1.22–7.70). In a multiple logistic regression model, both elevated apoB/apoA–I ratio and plaque occurrence in the femoral artery were of significant importance for cardiovascular events during follow-up. Conclusions The results showed that the apoB/apoA–I ratio was associated with arteriosclerosis in the femoral artery, and predicted future cardiovascular events. These observations, and the fact that apoB and apoA–I can be measured in the non-fasting state with high precision, in combination with the finding that LDL cholesterol did not predict cardiovascular disease, support results from other studies that the apoB/apoA–I ratio may be a superior risk marker for cardiovascular disease.