Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:910-6 - Vol. 71 Num.11 DOI: 10.1016/j.rec.2018.01.027

Analysis of Plasma Albumin, Vitamin D, and Apolipoproteins A and B as Predictive Coronary Risk Biomarkers in the REGICOR Study

Gabriel Vázquez-Oliva a,b, Alberto Zamora a,c,d, Rafel Ramos a,e,f, Isaac Subirana g,h, María Grau d,g, Irene R. Dégano d,g,i, Daniel Muñoz j,k, Montserrat Fitó j,k, Roberto Elosua d,g,i, Jaume Marrugat d,g,

a Facultad de Medicina, Universidad de Girona, Girona, Spain
b Departamento de Cardiología, Fundación Althaia, Manresa, Barcelona, Spain
c Unidad de Riesgo Vascular, Hospital de Blanes, Corporación de Salud del Maresme y la Selva, Blanes, Girona, Spain
d Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
e Instituto Universitario de Investigación en Atención Primaria (IDIAP) Jordi Gol, Grupo de Investigación ISV, Unidad de Investigación en Atención Primaria, Girona, Spain
f Atención Primaria, Instituto Catalán de Salud (ICS), Girona, Spain
g Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
h Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
i Universidad de Vic-Central de Cataluña (UVic-UCC), Vic, Barcelona, Spain
j Grupo de Nutrición y Riesgo Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
k Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain

Keywords

Albumin. Vitamin D. Apolipoprotein A1. Apolipoprotein B. Risk functions.

Abstract

Introduction and objectives

New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function.

Methods

A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths.

Results

Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048).

Conclusions

Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions.

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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