Association Between Apo B/Apo A1 And Severity Of Coronary Artery Disease In Postmenopausal Women

Objective:The purpose of this study was to investigate the relationship between Apo B/Apo A1 and the severity of coronary artery disease in postmenopausal women with coronary heart disease.The value of Apo B/Apo A1 in predicting the severity of coronary artery disease in postmenopausal women was also analyzed.Method:From January 2016 to December 2016,in the center of jilin university first hospital cardiovascular internal medicine disease diagnosis and treatment center hospital and identify the atherosclerotic process in the diagnosis of coronary heart disease(hereinafter referred to as the "coronary heart disease")of 450 cases of postmenopausal women,as the research object,the object of study of the average age of62.65±7.41 years,all the patients were through the line via radial artery or femoral artery path Judkins method coronary artery angiography,reading the results by two or more than two qualifications rich cardiologists.According to the results of coronary angiography,one or more vascular diameter measuring coronary stenosis 50% or higher is defined as a meaningful lesions,namely for coronary heart disease,according to theSyntax score standard again divided into low risk group(286 cases)and the high risk group(164 cases),and according to the blood vessel coronary vascular count divided into single vascular lesion group(226cases)and vascular lesion group(224 cases).General data were recorded in each group,including age,smoking history,history of hypertension,history of diabetes mellitus,Body mass index(BMI),and laboratory tests including white blood cell(WBC),red blood cell(RBC),hemoglobin(HGB),hematocrit(HCT),mean corpuscular hemoglobin concentration(MCHC),average red blood cell volume distribution width(RDW),Platelet(PLT),and Fibrinogen(FIB),D-dimer,uric acid,glucose,Alanine aminotransferase(ALT),Aspartate aminotransferase(AST),Total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(Apo A1),apolipoprotein B(Apo B),lipoprotein[Lp(a)].SPSS 20.0software was used for statistical analysis of the above clinical data.Results:1.Among the 450 patients with coronary heart disease in postmenopausal women included in this study,according to SYNTAX score standard,286 in the low-risk group and 164 in the medium-high risk group.Compared with the low-risk group,the AST,PLT,Apo B/Apo A1,Apo B ratio of the medium-high risk group was higher than that of the low-risk group(P < 0.05).Age,smoking history,history ofhypertension,history of diabetes,body mass index,Fasting plasma glucose,D-dimer,uric acid,ALT,WBC,RBC,HGB,HCT,MCHC,RDW,FIB,TC,TG,HDL-C,LDL-C,Apo A1,Lp(a)showed no significant difference between the two groups(P > 0.05).2.Logistic regression analysis showed that the risk of severe coronary artery disease in postmenopausal women with high PLT level was 1.006 times higher than that in postmenopausal women with low PLT level(P < 0.05).The incidence of severe coronary artery disease in postmenopausal women with high Apo B level was 3.622 times higher than that in postmenopausal women with low Apo B level(P < 0.05).The risk of severe coronary artery disease in postmenopausal women with high Apo B/Apo A1 level was 6.542 times higher than that in postmenopausal women with low Apo B/Apo A1 level(P < 0.05).3.Among the 450 cases of coronary heart disease in postmenopausal women included in this study,226 cases were in the single-vessel disease group and 224 cases were in the multi-vessel disease group.The levels of Apo B,Apo B/Apo A1 and PLT in the single-vessel disease group were lower than those in the multi-vessel disease group(P < 0.05),and the proportion of the former smoking history in the multi-vessel disease group was higher than that in the single-vessel disease group(P < 0.05).However,there was no significant difference in age,history of hypertension,history of diabetes,body mass index,Fasting plasmaglucose,D-dimer,uric acid,ALT,AST,FIB,TC,TG,WBC,RBC,HGB,HCT,HDL-C,LDL-C,MCHC,RDW,Apo A1,Lp(a)between the two groups(P > 0.05).4.Logistic regression analysis showed that the probability of multivessel disease in postmenopausal women caused by high Apo B/Apo A1 level was 2.809 times higher than that of coronary heart disease in postmenopausal women with low Apo B/Apo A1 level(P <0.05).High PLT level was 1.007 times more likely to cause multivessel disease in postmenopausal women than low PLT level was 1.007 times more likely to cause coronary heart disease in postmenopausal women(P< 0.05).High Apo B level was 2.284 times more likely to cause multivessel disease in postmenopausal women than low Apo B level was2.284 times more likely to cause coronary heart disease in postmenopausal women(P < 0.05).The possibility of smoking induced multivessel disease in postmenopausal women was 1.914 times higher than that in non-smoking postmenopausal women(P < 0.05).5.ROC curve was applied to analyze the predictive value of Apo B/Apo A1 for the severity of coronary artery disease in postmenopausal women with coronary artery disease.AUC was 0.67(95%CI:0.619-0.721),and the optimal cut-off point was 1.025,at which time the sensitivity and specificity of the prediction were 53.0% and 67.5%,respectively.This indicates that the level of Apo B/Apo A1 on admissionhas certain specificity in predicting the severity of coronary artery disease in postmenopausal women with coronary heart disease.Conclusion:1.Smoking history,PLT,Apo B/Apo A1 and Apo B are independent risk factors for multivessel disease in postmenopausal women with coronary heart disease.2.PLT,Apo B/Apo A1 and Apo B are independent risk factors for aggravating the severity of coronary artery disease in postmenopausal women with coronary heart disease.3.The increased Apo B/Apo A1 ratio has a certain specificity in predicting the severity of coronary artery disease in postmenopausal women with coronary heart disease,and can be used as a simple and easy laboratory examination index for grassroots and outpatient doctors to evaluate the high-risk patients with coronary heart disease in postmenopausal women.