HDL Apolipoproteomic Score Linked to Presence of Coronary Artery Disease

An HDL apolipoproteomic score was associated with the presence of coronary artery disease, independent of other conventional cardiovascular risk factors.

A high-density lipoprotein (HDL) apolipoproteomic score is associated with the presence of coronary artery disease (CAD), according to results published in the Journal of the American College of Cardiology. The results also indicated that for patients with CAD, HDL apolipoproteomic score may be associated with cardiovascular death.

The study included 943 participants without prevalent myocardial infarction (MI) who had been referred for coronary angiography in the CASABLANCA study (Catheter Sampled Blood Archive in Cardiovascular Diseases; ClinicalTrials.gov identifier: NCT00842868). The researchers measured HDL-associated apolipoprotein (apo) A-1, apoC-1, apoC-2, apoC-3, and apoC-4 in each participant.

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The researchers calculated a composite HDL apolipoproteomic score (pCAD) to determine associations between likelihood of obstructive CAD (≥70% lesion in ≥1 vessel) and with incident cardiovascular outcomes over 4 years of follow-up.

Overall, 62.2% (n=587) participants had coronary stenosis. The results indicated that pCAD score was associated with the presence of obstructive CAD (odds ratio [OR], 1.39; 95% CI, 1.14-1.69; P <.001), independent of conventional cardiovascular risk factors.

The C-index for pCAD was 0.63 (95% CI, 0.59-0.67) for the presence of obstructive CAD.

The researchers determined that pCAD was not associated with cardiovascular mortality among all participants (hazard ratio [HR], 1.24; 95% CI, 0.93-1.66; P =.15). However, they did find that pCAD was associated with cardiovascular mortality among participants with obstructive CAD (HR, 1.48; 95% CI, 1.07-2.05; P =.019).

“Our study highlights that atherosclerosis is influenced by a complex interplay of apolipoproteins across lipoprotein species; quantification of these components can inform risk and prognosis,” the researchers wrote.


Natarajan P, Collier TS, Jin Z, et al. Association of an HDL apolipoproteomic score with coronary atherosclerosis and cardiovascular death. J Am Coll Cardiol. 2019;73(17):2135-2145.