High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study
High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study
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DOI：
10.1016/s0140-6736(01)07098-2
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发表时间：
2001-12-15
期刊：
影响因子：
168.9
通讯作者：
Steiner, E
中科院分区：
文献类型：
--
作者：
Walldius, G;Jungner, I;Steiner, E
载脂蛋白B（apoB）和载脂蛋白A-I（apoA-I）被认为是比总胆固醇和低密度脂蛋白胆固醇更好的急性心肌梗死预测因子。我们研究了apoB和apoA-I是否是致死性心肌梗死风险的预测因子。我们还旨在建立是否载脂蛋白B和载脂蛋白A-I增加了进一步的信息，获得与总胆固醇，甘油三酯和LDL-cholesterol.Methods的致命性心肌梗死的风险，我们招募了175 553人，主要是从筛选程序。我们测量了apoB、apoA-I、总胆固醇和甘油三酯的浓度，并计算了apoB/apoA-I比值以及LDL-胆固醇和HDL-胆固醇的浓度。急性心肌梗死的死亡和载脂蛋白B，载脂蛋白A-I，和其他lipids的初始值之间的关系examined.Findings平均随访时间为66.8个月（SD 41.3）为98722名男性和64.4个月（41.4）为76831名女性。864名男性和359名女性发生致命性心肌梗死。在校正了年龄的单变量分析和校正了年龄、总胆固醇和甘油三酯的多变量分析中，apoB和apoB/apoA-I比值与男性和女性致死性心肌梗死的风险增加密切相关。发现ApoA-I具有保护作用。在多变量分析中，载脂蛋白B是一个更强的预测风险比LDL-胆固醇在both sexual.Interpretation虽然LDL-胆固醇和HDL-胆固醇是已知的危险因素，我们建议，载脂蛋白B，载脂蛋白B/载脂蛋白A-I，载脂蛋白A-I也应该被视为高度预测心脏风险的评估。尽管在LDL-胆固醇值的整个范围内升高，但apoB和apoA-I可能在具有常见脂质异常但LDL-胆固醇浓度正常或低的男性和女性的诊断和治疗中具有最大价值。
Background Apolipoprotein B (apoB) and apolipoprotein A-I (apoA-I) are thought to be better predictors of acute myocardial infarction than total cholesterol and LDL-cholesterol. We investigated whether apoB and apoA-I are predictors of risk of fatal myocardial infarction. We also aimed to establish whether apoB and apoA-I add further information about risk of fatal myocardial infarction to that obtained with total cholesterol, triglycerides, and LDL-cholesterol.Methods We recruited 175 553 individuals mainly from screening programmes. We measured concentrations of apoB, apoA-I, total cholesterol, and triglycerides, and calculated apoB/apoA-I ratio and concentrations of LDL-cholesterol and HDL-cholesterol. The relation between death from acute myocardial infarction and initial values for apoB, apoA-I, and the other lipids was examined.Findings Mean follow-up was 66.8 months (SD 41.3) for 98 722 men and 64.4 months (41.4) for 76 831 women. 864 men and 359 women had fatal myocardial infarction. In univariate analyses adjusted for age and in multivariate analyses adjusted for age, total cholesterol, and triglycerides, the values for apoB and apoB/apoA-I ratio were strongly and positively related to increased risk of fatal myocardial infarction in men and in women. ApoA-I was noted to be protective. In multivariate analysis, apoB was a stronger predictor of risk than LDL-cholesterol in both sexes.Interpretation Although LDL-cholesterol and HDL-cholesterol are known risk factors, we suggest that apoB, apoB/apoA-I, and apoA-I should also be regarded as highly predictive in evaluation of cardiac risk. Although increased throughout the range of values of LDL-cholesterol, apoB and apoA-I might be of greatest value in diagnosis and treatment in men and women who have common lipid abnormalities, but have normal or low concentrations of LDL-cho le sterol.