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Abstract 18834: IF1 And ApoA-I Serum Concentrations, but Not HDL-cholesterol, Predict Mortality in Coronary Artery Disease Patients: The Genes Study


 Introduction:
 High-density lipoprotein cholesterol (HDL-C) may not be the best clinical measure of HDL for assessing cardiovascular risk. Serum inhibitor factor 1 (IF1), an endogenous inhibitor of the ecto-F1-ATPase apoA-I receptor, has been identified as an independent determinant of HDL-C associated with low risk of coronary artery disease (CAD).
 
 
 Objective:
 To determine the relationship between serum IF1 concentration and mortality in stable CAD patients in comparison with HDL-C and apoA-I
 
 
 Methods:
 Serum IF1 was measured in 577 coronary male patients (enrollment age 45-74 years; enrollment period, 2001-2004) from the GENES (Genetique et ENvironement en Europe du Sud) study. Vital status was assessed yearly through December 31, 2013.
 
 
 Results:
 During a median follow up of 11 years, mortality rate was 29.5%. Cardiovascular mortality accounted for the majority (62.5%) of deaths. Serum IF1 (median value: 0.42 mg/mL) was positively correlated with HDL-C and apoA-I, and negatively with triglycerides and the severity of CAD (Gensini, Duke-Jeopardy scores). Mortality was lower the higher the quartile score for IF1 and apoA-I, but not for HDL-C. Inverse associations of IF1 and apoA-I with mortality remained significant, even after multivariate adjustments for classical cardiovascular risk factors - age, smoking, diabetes, dyslipidemia, waist circumference, physical activity and CRP. Furthermore, associations of the highest IF1 quartile with mortality reduction remained significant after further adjustment for clinical parameters proven to be predictive of complications in CAD patients, such as ankle-brachial index, heart rate and CAD duration. Interestingly, when levels of both IF1 and apoA-I were high, mortality was much lower than when only one of these was high.
 
 
 Conclusions:
 IF1 is a new biological marker strongly predictive of mortality in CAD patients. Among patients with normal or elevated apoA-I levels, IF1 measurement may help to identify those who are at low risk of complications and those who are not. IF1 measurement could be use in a panel of other emerging biomarkers that have been proven to be better than HDL-C level, for the better assessment of cardiovascular risk or in the setting of pharmacotherapy.
