Document Detail


Multiple lipid scoring system for prediction of coronary heart disease risk: application to African Americans.
MedLine Citation:
PMID:  17128681     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinicians often obtain a panel of lipids but then only use low-density-lipoprotein (LDL) cholesterol to make clinical decisions. We previously described the multiple lipid measure, a strategy that integrates information about seven lipid measures. Our current inquiry uses the multiple lipid measure to create a scoring system and validates that system in a second cohort. METHODS AND RESULTS: A scoring system that uses total cholesterol, high-density lipoprotein (HDL) cholesterol, LDL cholesterol and triglycerides was developed and tested. African-American participants of the Atherosclerosis Risk in Communities (ARIC) Study were used to validate the multiple lipid measure score. For nonsmokers, scores > or = 2 had a hazard ratio of 4.25 (95% CI 1.92-9.40) compared to reference scores of < or = -3 in adjusted survival analysis predicting incident coronary heart disease risk in the ARIC. The best conventional single lipid measure for nonsmokers was LDL cholesterol. Compared to LDL cholesterol <100 mg/dl, those with LDL cholesterol > or = 160 mg/dl had a hazard ratio of 2.31 (95% CI 1.13-4.75). For current smokers, the best conventional lipid measure was the total cholesterol/HDL cholesterol ratio, which was similar in predictive ability to the multiple lipid measure score. However, the multiple lipid measure score predicted an additional 10% of the cohort at risk compared to the total cholesterol/HDL cholesterol ratio. CONCLUSIONS: The use of the multiple lipid scoring system improves the assessment of incident coronary heart disease risk and may have utility for clinicians in integrating lipid values.
Authors:
Charles J Everett; Arch G Mainous; Richelle J Koopman; Vanessa A Diaz
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the National Medical Association     Volume:  98     ISSN:  0027-9684     ISO Abbreviation:  J Natl Med Assoc     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-28     Completed Date:  2006-12-19     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7503090     Medline TA:  J Natl Med Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1740-5     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, Medical University of South Carolina, 295 Calhoun St., PO Box 250192, Charleston, SC 29425, USA. everettc@musc.edu
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MeSH Terms
Descriptor/Qualifier:
African Americans / statistics & numerical data*
Apolipoproteins B / blood
Cholesterol / blood
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Coronary Artery Disease / blood,  ethnology
Coronary Disease / blood*,  epidemiology,  ethnology*
Health Status Indicators
Humans
Lipids / blood*
Middle Aged
Predictive Value of Tests
Risk Assessment
Grant Support
ID/Acronym/Agency:
2 D54 HP-00023//PHS HHS
Chemical
Reg. No./Substance:
0/Apolipoproteins B; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Lipids; 57-88-5/Cholesterol
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