Abstract 9360: Increasing Mass Transfer Flux of Low-Density Lipoproteins-Cholesterol or Apolipoprotein B at the Endothelium of Atherogenic Sites as a Primary Target of Atherosclerotic Cardiovascular Disease

Abstract

Major pathological evidences indicate that subendothelial low-density lipoproteins-cholesterol (LDL-c) accumulations at atherogenic sites cause atheroscleroticcardiovascular disease (ACD). As such, current guidelines focus on LDL-c as aprimary target of ACD. Accumulating data from clinical trials have suggested thata shift from LDL-c to apolipoprotein B (Apo B) may improve target accuracy. Inthis study, we assess the hypothesis that focuses on increasing mass transfer flux ofLDL-c or Apo B from the disturbed blood flow to the endothelium of atherogenicsites as a primary target of ACD. A set of multidisciplinary analysis models areused to describe dynamic behaviors of LDL-c or Apo B particles and create amultibiomarker analysis formula (MAF) for the assessment, prevention andtreatment of ACD. The models reveal that individuals’ atheroscleroticmultibiomarker such as elevated LDL-c levels or increasing Apo B, hypertension,rising heart rate and increasing atrial stiffness contribute to an increase in LDL-c orApo B mass transfer flux at the endothelium of atherogenic sites and the increasingLDL-c flux then directly triggers subendothelial LDL-c accumulations at the sites.Excitingly, we show that the individual ACD risks assessed by MAF correspondrobustly to the 2013 ACC/AHA Guideline. In conclusion, LDL-c or Apo B masstransfer flux at the endothelium of atherogenic sites is a primary target of ACD andthe flux combines the contributions of different biomarkers to ACD. MAFencompasses a multibiomarker approach that has been utilized to analyzescreening data from over 95,000 patients conducted by the Cleveland Heart Laband MDVIP, Inc., which highlights the potential to prevent ACD and savehundreds of millions of dollars in healthcare costs.