KHẢO SÁT NỒNG ĐỘ APOLIPOPROTEIN B Ở BỆNH NHÂN HỘI CHỨNG MẠCH VÀNH CẤP

Abstract

Background: Apolipoprotein B (ApoB)-containing lipoproteins play a central role in the initiation and progression of atherosclerosis. ApoB quantification directly estimates the total number of atherogenic lipoprotein particles, including very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and low-density lipoprotein (LDL). Therefore, the 2019 ESC Guidelines and the 2020 EAS/EFLM consensus recommend ApoB as a superior marker for cardiovascular risk assessment compared to LDL-C or non-HDL-C. ApoB measurement is particularly recommended (Class IC) in patients with mild-to-moderate hypertriglyceridemia (2–10  mmol/L), diabetes, obesity or metabolic syndrome, or very low LDL-C. In Vietnam, ApoB testing is not yet widely adopted in clinical practice, and research on ApoB in coronary artery disease remains limited. Objectives: To describe the characteristics of ApoB in patients with acute coronary syndrome (ACS) and to evaluate the association of ApoB with cardiovascular risk factors, as well as its correlation with LDL-C and non-HDL-C. Methods: A descriptive cross-sectional study was conducted on 165 patients diagnosed with ACS at the Interventional Cardiology Department, Cho Ray Hospital, from December 2020 to May 2021. Results: The mean age of the 165 ACS patients was 60.5 ± 11.5 years, with females accounting for 40%. ST-elevation myocardial infarction (STEMI) comprised nearly two-thirds of cases, and 94% of patients underwent coronary angiography. The prevalence of metabolic syndrome was 64%. Serum ApoB levels were normally distributed, with a mean of 109.4 ± 29.5 mg/dL and a median of 106 mg/dL. The prevalence of elevated ApoB levels was 87.3% at the 80 mg/dL cutoff and 6T.6% at the 100 mg/dL cutoff. ApoB was significantly associated with elevated triglycerides, metabolic syndrome, and overweight-obesity (p < 0.05), whereas LDL-C showed no such associations. ApoB demonstrated a strong correlation with LDL-C (r = 0.79) and non-HDL-C (r = 0.86). Conclusions: Serum ApoB levels were normally distributed, with a mean of 109.4 ± 29.5 mg/dL. The prevalence of elevated ApoB levels at the 80 mg/dL and 100 mg/dL cutoffs was 87.3% and 60.6%, respectively. ApoB was significantly associated with elevated triglycerides, metabolic syndrome, and overweight-obesity, supporting its role as a more accurate marker of cardiovascular risk than LDL-C.