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RECENT PUBLICATIONS ON RESIDUAL RISK

2020

Apolipoprotein CIII levels predict recurrent cardiovascular events

inhibition of lipoprotein lipase and hepatic very low-density lipoprotein (VLDL) uptake, and increased hepatic VLDL secretion. In addition, apoCIII promotes VLDL formation and assembly and has proinflammatory and prothrombotic effects. Mendelian randomization studies have indicated a causal association between apo CIII and cardiovascular disease, as carriers of loss-of-function mutations in APOC3 had 40% lower TG levels and a 40% reduction in risk of coronary artery disease. These findings were also supported by prospective observational studies linking apoCIII levels and incident coronary artery disease. However, whether this association is also applicable to postprandial apoCIII levels is uncertain. This study addressed this, by investigating changes in apoCIII concentration after a standardized oral fat load test and whether both fasting and postprandial apoCIII levels predict disease progression in coronary artery disease patients, comparing native versus chylomicron-free serum.
 
The study included 195 patients from the prospective Homburg Cream and Sugar study, 92 with a prior cardiovascular event. Almost all (97%) were treated with a statin. There were no significant changes in apoCIII concentration after the oral fat load test. Importantly, apoCIII concentration in chylomicron-free serum was independently associated with event-free survival in coronary artery disease patients in both fasting (Hazard ratio 2.09, 95% confidence interval 1.32-3.32, p = 0.002), and postprandial (Hazard ratio 1.67, 1.06–2.29, p = 0.028) states. On the basis of their findings, the authors proposed that apoCIII, measured in chylomicron-free serum, may have utility as a risk marker to predict residual cardiovascular risk.
Apolipoprotein CIII predicts cardiovascular events in patients with coronary artery disease: a prospective observational study.

Katzmann JL, Werner CM, Stojakovic T, et al.