Combined impacts of low apolipoprotein A-I levels and reduced renal function on long-term prognosis in patients with coronary artery disease undergoing percutaneous coronary intervention

Background and aims: The relationship of apolipoprotein A-I (ApoA-I) and renal function in patients after intervention remain unclear, thus, we aimed to evaluate the combined impacts of ApoA-I and kidney disease (K-D). Material and methods: Altogether, 4101 consecutive patients who underwent intervention between 2000 and 2016 were included. The patients were divided into four groups based on the median ApoA-I values and presence of K-D. We evaluated the incidence of major adverse cardiac and cerebrovascular events (MACCE), including cardiovascular death, non-fatal acute coronary syndrome and non-fatal stroke, and all-cause death. Results: During the median follow-up period of 6.2 years, 618 patients (15.1%) developed MACCE, and 627 patients (15.3%) died. ApoA-I level was significantly related to estimated glomerular filtration rate, and ApoA-I levels and K-D status interaction term was statistically significant. Kaplan-Meier analysis revealed that the low ApoA-I with K-D had the significantly highest cumulative incidence rate of MACCE and all-cause death compared to the other three groups. Additionally, ApoA-I levels and K-D status were independent predictors of MACCE and all-cause death in multivariable Cox hazard analysis. Conclusion: The combined impacts of ApoA-I and renal function could be useful for evaluating cardiovascular and life prognoses in patients undergoing intervention.

Automated summary

This study examined the combined impacts of ApoA-I and renal function in patients after intervention, revealing that patients with low ApoA-I levels and K-D had the highest cumulative incidence rate of MACCE and all-cause death. ApoA-I levels and K-D status were independent predictors of MACCE and all-cause death.