CARDIOVASCULAR PROGNOSIS IN RELATION TO APOLIPOPROTEINS AND OTHER LIPID PARAMETERS IN PATIENTS WITH STABLE ANGINA-PECTORIS TREATED WITH VERAPAMIL OR METOPROLOL - RESULTS FROM THE ANGINA PROGNOSIS STUDY IN STOCKHOLM (APSIS)

Relationships between apolipoproteins and other lipid parameters and c ardiovascular (CV) prognosis were evaluated in the Angina Prognosis St udy In Stockholm (APSIS). Out of 809 patients with stable angina pecto ris, lipid variables were obtained in 786 patients at baseline, and af ter one month's double-blind treatment with metoprolol or verapamil, t o evaluate treatment effects on these lipid variables. During a median follow-up time of 3.3 years (2663 patient years), 37 patients suffere d a CV death, 30 suffered a non-fatal myocardial infarction (MI) and 1 00 underwent a revascularization. Apolipoprotein (ape) A-I, high-densi ty lipoprotein cholesterol and triglycerides were predictors of CV dea th or non-fatal MI in univariate analyses, but only apo A-I remained a s an independent predictor in multivariate analyses. All lipid variabl es except low density lipoprotein cholesterol were related to the risk of revascularization in univariate analyses, but only apo A-I and apo B were independent predictors of such events. Triglycerides were weak ly, but not independently, associated with prognosis. Verapamil and me toprolol had differential short-term effects on lipids, with a shift t owards a mon atherogenic profile in metoprolol treated patients. Howev er, there was no significant impact of the treatment given, or of thes e treatment effects on the risk of CV events. Results of the present s tudy suggest that apolipoprotein levels were better predictors of CV e vents than other lipid parameters in patients with stable angina pecto ris. (C) 1997 Elsevier Science Ireland Ltd.