Combined impacts of low apolipoprotein A-I levels and reduced renal function on long-term prognosis in patients with coronary artery disease undergoing percutaneous coronary intervention

Clin Chim Acta. 2022 Nov 1:536:180-190. doi: 10.1016/j.cca.2022.09.020. Epub 2022 Oct 4.

Abstract

Background and aims: The relationship of apolipoprotein A-I (ApoA-I) and renal function in patients after intervention remain unclear, thus, we aimed to evaluate the combined impacts of ApoA-I and kidney disease (KD).

Material and methods: Altogether, 4101 consecutive patients who underwent intervention between 2000 and 2016 were included. The patients were divided into four groups based on the median ApoA-I values and presence of KD. We evaluated the incidence of major adverse cardiac and cerebrovascular events (MACCE), including cardiovascular death, non-fatal acute coronary syndrome and non-fatal stroke, and all-cause death.

Results: During the median follow-up period of 6.2 years, 618 patients (15.1%) developed MACCE, and 627 patients (15.3%) died. ApoA-I level was significantly related to estimated glomerular filtration rate, and ApoA-I levels and KD status interaction term was statistically significant. Kaplan-Meier analysis revealed that the low ApoA-I with KD had the significantly highest cumulative incidence rate of MACCE and all-cause death compared to the other three groups. Additionally, ApoA-I levels and KD status were independent predictors of MACCE and all-cause death in multivariable Cox hazard analysis.

Conclusion: The combined impacts of ApoA-I and renal function could be useful for evaluating cardiovascular and life prognoses in patients undergoing intervention.

Keywords: All-cause death; Apolipoprotein A-I; Cardiovascular events; Kidney disease; Long-term prognosis; Percutaneous coronary intervention.

MeSH terms

  • Apolipoprotein A-I
  • Coronary Artery Disease* / etiology
  • Coronary Artery Disease* / surgery
  • Humans
  • Kidney / physiology
  • Percutaneous Coronary Intervention* / adverse effects
  • Prognosis
  • Risk Factors
  • Treatment Outcome

Substances

  • Apolipoprotein A-I