Comparison Of Apo B/A1, Lipoprotein (A) And LDL-C/Apo B For Predicting Coronary Atherosclerosis In Patients ≤65 Years With Low LDL-C

Background: High low-density lipoprotein cholesterol (LDL-C) and old age are major risk factors for coronary artery disease. However, the risk factors for coronary artery disease in relatively young patients with low LDL-C have not been elucidated. Therefore, we performed this study to evaluate the risk factors of coronary artery disease, in patients under 65 years with low LDL-C. Methods: This study included 622 lipid-lowering agent naive patients ≤65 years with LDL-C <127.5 mg/dL who underwent coronary computed tomographic angiography. We performed multivariate logistic regression analysis to evaluate the risk factors of coronary atherosclerosis, defined as the presence of coronary plaque. In addition to traditional cardiovascular risk factors, the covariate included novel lipid profiles (apolipoprotein (Apo) B/Apo A1) ratio, LDL-C/Apo B ratio, and lipoprotein (a)). Results: Of the total 622 patients, the mean age was 54.4 ± 8.9 and the mean LDL-C was 91.0 ± 23.1 mg/dL. Multivariate regression analysis showed that age, male, diabetes mellitus, and hypertension were independent predictors of coronary atherosclerosis. A high LDL-C/Apo B ratio was a negative predictor of coronary atherosclerosis. Conclusions: A low LDL-C/Apo B ratio is associated with the development of coronary atherosclerosis in patients ≤65 years with low LDL-C levels.