Apolipoprotein C3 and necrotic core volume are correlated but also associated with future cardiovascular events

Abstract

We aimed to clarify the relationship between apolipoprotein C3 (apo-C3) and the vascular composition of lesion plaque in stable coronary disease (SCD) before percutaneous coronary intervention (PCI), and to investigate major adverse cardiovascular events (MACEs) within 4 years. Data of 98 consecutive patients with SCD who underwent PCI between November 1, 2012, and March 10, 2015, were analyzed. Laboratory and virtual histology-intravascular ultrasound (VH-IVUS) examinations of culprit lesions were conducted before PCI. Patients were divided according to median apo-C3 into low apo-C3 (≤ 8.5 mg/dL) and high apo-C3 (> 8.5 mg/dL) groups. VH-IVUS data indicated that the percentage of necrotic core volume (%NC) was significantly higher in the high apo-C3 group than in the low apo-C3 group. Moreover, the %NC significantly correlated with the apo-C3 level (R = 0.2109, P = 0.037). Kaplan–Meier curve analysis revealed that freedom from MACEs exhibited a greater decrease in the high apo-C3 group than in the low apo-C3 group, and in the high %NC group than in the low %NC group. Multivariate Cox hazards analysis showed that the %NC and high apo-C3 were independent predictors of 4 year MACEs. Apo-C3 may be a useful marker of future MACEs in patients with SCD after PCI and contribute to %NC growth.

Apolipoprotein C3: form begets function

“…Third, studies in animal models, including in a mouse model of type 1 diabetes, have shown that silencing of APOC3 prevents the formation of both early and advanced lesions of atherosclerosis characterized by necrotic core expansion ( 10 , 11 , 12 ), while mice transgenic for human APOC3 have 2- to 3-fold larger atherosclerotic lesions than controls ( 13 ). These findings in mice are consistent with an intravascular ultrasound study in humans, which demonstrated that the percentage of necrotic core volume in culprit lesions and the risk of a future CVD event were higher in participants with high plasma levels of APOC3 (>8.5 mg/dl) than in participants with APOC3 levels below that threshold ( 14 ). Together, these studies provide strong support for APOC3 as both a biomarker and causal mediator of atherosclerotic CVD.…”

Management of dyslipidemia in coronary artery disease: the present and the future

“…Especially for patients with CAD treated with PCI, those with apoC3 concentrations below the median (8.5 mg/ dl) had a significantly greater percentage of necrotic core volume, with those two factors being predictive of incident major adverse cardiovascular events [65].…”

“…ApoC3 may also possess prognostic properties since it has been related to incident diabetes, CAD, and adverse cardiovascular outcomes [59–64]. Especially for patients with CAD treated with PCI, those with apoC3 concentrations below the median (8.5 mg/dl) had a significantly greater percentage of necrotic core volume, with those two factors being predictive of incident major adverse cardiovascular events [65].…”