Apolipoprotein C3 and Necrotic Core Volume Are Correlated but Also Associated With Future Cardiovascular Events

We aimed to clarify the relationship between apolipoprotein C3 (apo-C3) and 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 evaluation and virtual histology-intravascular ultrasound (VH-IVUS) examination of culprit lesions were conducted before PCI. Patients were divided according to the median apo-C3 value 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 decreased more 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 for future MACEs in patients with SCD after PCI and contribute to %NC growth.