Low apolipoprotein A1 was associated with increased risk of cancer mortality in patients following percutaneous coronary intervention: A 10‐year follow‐up study

• Published in: International journal of cancer 2022-11, Vol.151 (9), p.1482-1490
• Main Authors: Nishiyama, Hiroki, Funamizu, Takehiro, Iwata, Hiroshi, Endo, Hirohisa, Chikata, Yuichi, Doi, Shinichiro, Wada, Hideki, Naito, Ryo, Ogita, Manabu, Kato, Yoshiteru, Okai, Iwao, Dohi, Tomotaka, Kasai, Takatoshi, Isoda, Kikuo, Okazaki, Shinya, Miyauchi, Katsumi, Minamino, Tohru
• Format: Article
• Language: English
• Subjects: Angioplasty; apolipoprotein A1; Apolipoproteins; Cancer; cancer mortality; Cardiovascular diseases; Cholesterol; High density lipoprotein; high‐density lipoprotein cholesterol; Lung cancer; Medical research; Mortality; percutaneous coronary intervention
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.34164

Previous studies showed that elevated apolipoprotein A1 (ApoA1) and high‐density lipoprotein cholesterol (HDL‐C) predicted reduced risk of cardiovascular‐related (CV) mortality in patients following percutaneous coronary intervention (PCI). Nevertheless, as the association between ApoA1 and cancer mortality in this population has been rarely addressed, our study aimed to evaluate prognostic impact of ApoA1 on multiple types of cancer mortality after PCI. This is a retrospective analysis of a single‐center prospective registry database of patients who underwent PCI between 2000 and 2018. The present study enrolled 3835 patients whose data of serum ApoA1 were available and they were divided into three groups according to the tertiles of the preprocedural level of ApoA1. The outcome measures were total, gastrointestinal, and lung cancer mortalities. The median and range of the follow‐up period between the index PCI and latest follow‐up were 5.9 and 0‐17.8 years, respectively. Consequently, Kaplan‐Meier analyses showed significantly higher rates of the cumulative incidences of total, gastrointestinal, and lung cancer mortality in the lowest ApoA1 tertile group compared to those in the highest. In contrast, there were no significant differences in all types of cancer mortality rates in the groups divided by the tertiles of HDL‐C. Multivariable Cox proportional hazard regression analysis adjusted by cancer‐related prognostic factors, such as smoking status, identified the elevated ApoA1 as an independent predictor of decreased risk of total and gastrointestinal cancer mortalities. Our study demonstrates the prognostic implication of preprocedural ApoA1 for predicting future risk of cancer mortality in patients undergoing PCI. What's new? Cancer mortality has become one of the major clinical concerns in patients undergoing percutaneous coronary intervention (PCI). Apolipoprotein A plays a central role in the antiatherosclerotic effects of high‐density lipoprotein cholesterol and is also associated with reduced incidence of cancer and cancer mortality in the general population. The present study demonstrates that reduced preprocedural apolipoprotein A1 level is independently associated with increased risk of total and gastrointestinal cancer mortality following PCI. The findings indicate that serum apolipoprotein A1 level could be a useful prognostic indicator of cancer mortality in patients undergoing PCI.