Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions - The Atherosclerosis Risk in Communities (ARIC) Study
Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions - The Atherosclerosis Risk in Communities (ARIC) Study
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DOI：
10.1161/hc3501.095214
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发表时间：
2001-09-04
期刊：
影响因子：
37.8
通讯作者：
Patsch, W
中科院分区：
文献类型：
--
作者：
Sharrett, AR;Ballantyne, CM;Patsch, W
背景-尽管需要降低血胆固醇，以防止冠心病（CHD）的共识，现有的证据最佳胆固醇水平或额外的血脂的预测值是sparse.Methods和Results-After 10年的随访的12 339名中年参与者无CHD的动脉粥样硬化风险在社区研究（ARIC），725 CHD事件发生。在低密度脂蛋白胆固醇（LDL-C）最低的五分位数中观察到最低的发病率，女性中位数为88 mg/dL，男性为95 mg/dL，风险在较高水平加速，女性最高五分位数的相对风险（RR）为2.7，男性为2.5。LDL-C、HDL-C、脂蛋白（a）[Lp（a）]和甘油三酯（TG）在女性（而非男性）中均为独立的CHD预测因子，与血压、吸烟和糖尿病一起，女性RR为13.5，男性为4.9。黑人的Lp（a）水平不如白人显着。HDL-C密度亚组分或载脂蛋白（apo）A-I或B未增强预测。尽管有很强的单变量相关性，apoB对TG升高、LDL-C降低或apoB相对于LDL-C升高的亚组的风险预测没有贡献。
Background-Despite consensus on the need for blood cholesterol reductions to prevent coronary heart disease (CHD), available evidence on optimal cholesterol levels or the added predictive value of additional lipids is sparse.Methods and Results-After 10 years follow-up of 12 339 middle-aged participants free of CHD in the Atherosclerosis Risk in Communities Study (ARIC), 725 CHD events occurred. The lowest incidence was observed in those at the lowest LDL cholesterol (LDL-C) quintile, with medians of 88 mg/dL in women and 95 mg/dL in men, and risk accelerated at higher levels, with relative risks (RRs) for the highest quintile of 2.7 in women and 2.5 in men. LDL-C, HDL-C, lipoprotein(a) [Lp(a)], and in women but not men, triglycerides (TG) were all independent CHD predictors, providing an RR, together with blood pressure, smoking, and diabetes, of 13.5 in women and 4.9 in men. Lp(a) was less significant in blacks than whites. Prediction was not enhanced by HDL-C density subfractions or apolipoproteins (apo) A-I or B. Despite strong univariate associations, apoB did not contribute to risk prediction in subgroups with elevated TG, with lower LDL-C, or with high apoB relative to LDL-C.Conclusions-Optimal LDL-C values are