From the Guidelines
The patient's cardiac health is likely at low risk based on the provided apolipoprotein and CRP levels.
Apolipoprotein Analysis
- Apo A-1 level of 124 is within the normal range, as levels <120 mg/dL for men and <140 mg/dL for women are considered low for HDL-C 1.
- Apo B level of 77 is a good estimate of the number of atherogenic lipoprotein particles in plasma, and several prospective studies have shown that apo B is equal to LDL-C in risk prediction 1.
- Apo B/apo A-1 ratio of 0.6 is considered favorable, as it combines an apparently harmful (apo B) with an apparently protective (apo A1) lipoprotein variable, and a lower ratio is associated with lower cardiovascular risk 1.
Inflammation Analysis
- CRP level of 0.44 is relatively low, indicating low inflammation, which is a positive indicator of cardiac health.
Overall Assessment
Based on the provided evidence, the patient's apolipoprotein and CRP levels suggest a low risk of cardiovascular disease, as the apo B/apo A-1 ratio is favorable and the CRP level is low 1. However, it is essential to consider these results in the context of overall clinical assessment and other risk factors.
From the Research
Interpretation of Apolipoprotein and CRP Levels
- Apo A-1 level of 124: High levels of apo A-1 are associated with a lower risk of cardiovascular disease, as apo A-1 is a major component of high-density lipoprotein (HDL) cholesterol, which is considered "good" cholesterol 2, 3, 4.
- Apo B level of 77: Apo B is a component of low-density lipoprotein (LDL) cholesterol, which is considered "bad" cholesterol. High levels of apo B are associated with an increased risk of cardiovascular disease 2, 3, 4.
- Apo B/apo A-1 ratio of 0.6: This ratio represents the balance between proatherogenic and antiatherogenic lipoproteins. A lower ratio is associated with a lower risk of cardiovascular disease. The apo B/apo A-1 ratio is considered a better predictor of cardiovascular risk than traditional lipid ratios, such as total cholesterol/HDL cholesterol 5, 3, 6, 4.
- CRP level of 0.44: C-reactive protein (CRP) is a marker of inflammation, and high levels are associated with an increased risk of cardiovascular disease. However, the level of 0.44 is relatively low, which may indicate a lower level of inflammation 2.
Comparison to Study Findings
- The apo B/apo A-1 ratio of 0.6 is consistent with the findings of 5, which suggest that this ratio is a powerful predictor of future cardiovascular disease risk.
- The study by 6 found that the apo B/A1 ratio was a better predictor of future outcome than the total cholesterol/HDL-C ratio or lipoprotein (a) after percutaneous coronary intervention (PCI).
- The findings of 4 suggest that the apo B/apo A-1 ratio is superior to any of the cholesterol ratios in predicting the risk of coronary disease.
- The study by 2 found that apo B was associated with cardiovascular events, and that the apo B/apo A-1 ratio was a significant predictor of vascular risk.
Key Takeaways
- The apo B/apo A-1 ratio is a significant predictor of cardiovascular risk, and a lower ratio is associated with a lower risk of cardiovascular disease 5, 3, 6, 4.
- High levels of apo A-1 are associated with a lower risk of cardiovascular disease, while high levels of apo B are associated with an increased risk 2, 3, 4.
- The CRP level of 0.44 is relatively low, which may indicate a lower level of inflammation 2.