Serum palmitic acid–oleic acid ratio and the risk of coronary artery disease: a case-control study

Serum free fatty acids are risk factors for future coronary artery disease (CAD). We investigated the association between serum palmitic acid (PA)–oleic acid (OA) ratio and CAD risk in a case-control (n=108/129) study. The PA–OA ratio was associated with future CAD events independently of standard lipid values. The PA–OA ratio was significantly associated with the risk of fatal CAD [odds ratio (OR): 60.4; 95% confidence interval (CI): 11.5–316.9; P<.001] while inversely associated in nonfatal CAD group (OR: 0.11; 95% CI: 0.02–0.53; P<.01), and no distinct modification by sex was found. Receiver-operating characteristic (ROC) analysis found that PA–OA ratio did as well as triglyceride (TG) and apolipoprotein B (apo B)–high-density lipoprotein cholesterol (HDLC) ratio at discriminating fatal CAD (area under ROC, TG, 0.692; apo B–HDLC, 0.683; PA–OA, 0.768, P<.001), and had similar effect with HDLC at discriminating nonfatal CADs (area under ROC, HDLC, 0.649; PA–OA, 0.659, P<.01).These findings suggested that PA–OA ratio did as well as and even better than traditional risk factors and arteriography examination in discriminating fatal and nonfatal CAD events. Serum PA–OA ratio could be a new factor for CAD risk assessment and prediction.