Document Detail


Lipids and lipoproteins and risk of different vascular events in the MRC/BHF Heart Protection Study.
MedLine Citation:
PMID:  22539783     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol are established risk factors for vascular disease, but lipoprotein particle concentrations may be stronger determinants of risk.
METHODS AND RESULTS: Associations between vascular events and baseline concentrations of cholesterol fractions, apolipoproteins B and A(1), and lipoprotein particles assessed by nuclear magnetic resonance were considered in the Heart Protection Study randomized trial of simvastatin versus placebo (>5000 vascular events during 5.3 years of follow-up among 20 000 participants). Major occlusive coronary events were equally strongly associated with the cholesterol- and particle-based total LDL measures; adjusted hazard ratios per 1-SD-higher level were 1.25 (95% confidence interval [CI], 1.16-1.34) for LDL cholesterol, 1.22 (95% CI, 1.14-1.32) for non-HDL cholesterol, 1.23 (95% CI, 1.15-1.33) for apolipoprotein B, and 1.25 (95% CI, 1.16-1.35) for LDL particle number. Given the total LDL particle number, the distribution between small and large particles did not add predictive value. Associations of these different LDL-related measures were similar with arterial revascularization procedures but much weaker or nonexistent with ischemic stroke and other cardiac events (mainly heart failure). After adjustment for LDL particle number, the hazard ratios for major occlusive coronary event per 1-SD-higher level were 0.91 (95% CI, 0.86-0.96) for HDL cholesterol and 0.89 (95% CI, 0.85-0.93) for HDL particle number. Other cardiac events were inversely associated with total (hazard ratio, 0.84; 95% CI, 0.79-0.90) and small (0.82; 95% CI, 0.76-0.89) HDL particle number but only very weakly associated with HDL cholesterol (0.94; 95% CI, 0.88-1.00).
CONCLUSIONS: In a population at 2% average coronary event risk per year, cholesterol, apolipoprotein, and particle measures of LDL were strongly correlated and had similar predictive values for incident major occlusive vascular events. It is unclear whether the associations between HDL particle numbers and other cardiac events represent a causal or reverse-causal effect.
Authors:
Sarah Parish; Alison Offer; Robert Clarke; Jemma C Hopewell; Michael R Hill; James D Otvos; Jane Armitage; Rory Collins;
Related Documents :
7449923 - The synthesis of antibacterial proteins in isolated fat body from cecropia silkmoth pupae.
18815993 - Does habitual body avoidance and checking behavior influence the decrease of negative e...
21637473 - Association of homocysteine and methylene tetrahydrofolate reductase (mthfr c677t) gene...
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-04-26
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-22     Completed Date:  2012-07-24     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2469-78     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ISRCTN/ISRCTN48489393
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anticholesteremic Agents / administration & dosage
Arterial Occlusive Diseases* / blood,  epidemiology,  prevention & control
Cholesterol, HDL / blood*
Cholesterol, LDL / blood*
Coronary Artery Disease* / blood,  epidemiology,  prevention & control
Dyslipidemias* / blood,  drug therapy,  epidemiology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Placebos
Predictive Value of Tests
Proportional Hazards Models
Risk Factors
Simvastatin / administration & dosage*
Grant Support
ID/Acronym/Agency:
MC_U137686854//Medical Research Council; MC_U137686857//Medical Research Council; SP/08/010/25939//British Heart Foundation; //British Heart Foundation; //Medical Research Council
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Placebos; AGG2FN16EV/Simvastatin
Comments/Corrections
Comment In:
Circulation. 2012 May 22;125(20):2412-3   [PMID:  22539782 ]
Circulation. 2012 Nov 13;126(20):e321   [PMID:  23147773 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Deja Vu All Over Again.
Next Document:  Kinetics and Activation Requirements of Contact-Dependent Immune Suppression by Human Regulatory T C...