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Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS).
J Intern Med. 2008 Jul; 264(1):30-8.JI

Abstract

OBJECTIVES

Examine and compare lipoprotein components associated with fatal and nonfatal acute myocardial infarction (AMI) by time period in the Apolipoprotein MOrtality RISk (AMORIS) Study.

DESIGN

Prospective follow-up study of nonfatal and fatal myocardial infarction through linkage with Swedish hospital discharge and Swedish mortality registers.

SETTING

Measurements of lipoprotein components from health check-ups in the larger Stockholm area.

SUBJECTS

The AMORIS subjects (n = 149 121) free of AMI at blood sampling were followed from 1985 to 2002 with respect to n = 6794 first cases of AMI.

RESULTS

Hazard ratios of nonfatal and fatal AMI by lipoprotein parameters were highly significant and about equally strong in both genders. Apolipoprotein B (apoB), nonhigh density cholesterol and low density cholesterol predicted nonfatal AMI (NFAMI) better than fatal AMI, but high density cholesterol or apolipoprotein A-1 did not. Atherogenic components were weaker predictors after 1997 than before. In multivariate analyses apoB/apoA-1 was a better predictor than TC/HDL-C. ApoB/apoA-1 added clinically significant information to TC/HDL-C in men as reflected by a net reclassification improvement (NRI) of 9.4% (P < 0.0001).

CONCLUSION

ApoB, apoB/apoA-1 and non-HDL-C were found about equally predictive with LDL-C being slightly less, but multivariate analyses showed apoB/apoA-1 to be the strongest predictor. Attenuation of prediction ability between nonfatal and fatal AMI may be due to modern treatment of CHD after a NFAMI and attenuation of hazard ratios after 1997 may be due to selection of lower risk subjects surviving to 1997.

Authors+Show Affiliations

Department of Preventive Cardiology, Centre of Preventive Medicine, Ulleval University Hospital, Oslo, Norway. ingar.holme@uus.noNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18298486

Citation

Holme, I, et al. "Relationships Between Lipoprotein Components and Risk of Myocardial Infarction: Age, Gender and Short Versus Longer Follow-up Periods in the Apolipoprotein MOrtality RISk Study (AMORIS)." Journal of Internal Medicine, vol. 264, no. 1, 2008, pp. 30-8.
Holme I, Aastveit AH, Jungner I, et al. Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS). J Intern Med. 2008;264(1):30-8.
Holme, I., Aastveit, A. H., Jungner, I., & Walldius, G. (2008). Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS). Journal of Internal Medicine, 264(1), 30-8. https://doi.org/10.1111/j.1365-2796.2008.01925.x
Holme I, et al. Relationships Between Lipoprotein Components and Risk of Myocardial Infarction: Age, Gender and Short Versus Longer Follow-up Periods in the Apolipoprotein MOrtality RISk Study (AMORIS). J Intern Med. 2008;264(1):30-8. PubMed PMID: 18298486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS). AU - Holme,I, AU - Aastveit,A H, AU - Jungner,I, AU - Walldius,G, Y1 - 2008/02/21/ PY - 2008/2/27/pubmed PY - 2008/10/17/medline PY - 2008/2/27/entrez SP - 30 EP - 8 JF - Journal of internal medicine JO - J Intern Med VL - 264 IS - 1 N2 - OBJECTIVES: Examine and compare lipoprotein components associated with fatal and nonfatal acute myocardial infarction (AMI) by time period in the Apolipoprotein MOrtality RISk (AMORIS) Study. DESIGN: Prospective follow-up study of nonfatal and fatal myocardial infarction through linkage with Swedish hospital discharge and Swedish mortality registers. SETTING: Measurements of lipoprotein components from health check-ups in the larger Stockholm area. SUBJECTS: The AMORIS subjects (n = 149 121) free of AMI at blood sampling were followed from 1985 to 2002 with respect to n = 6794 first cases of AMI. RESULTS: Hazard ratios of nonfatal and fatal AMI by lipoprotein parameters were highly significant and about equally strong in both genders. Apolipoprotein B (apoB), nonhigh density cholesterol and low density cholesterol predicted nonfatal AMI (NFAMI) better than fatal AMI, but high density cholesterol or apolipoprotein A-1 did not. Atherogenic components were weaker predictors after 1997 than before. In multivariate analyses apoB/apoA-1 was a better predictor than TC/HDL-C. ApoB/apoA-1 added clinically significant information to TC/HDL-C in men as reflected by a net reclassification improvement (NRI) of 9.4% (P < 0.0001). CONCLUSION: ApoB, apoB/apoA-1 and non-HDL-C were found about equally predictive with LDL-C being slightly less, but multivariate analyses showed apoB/apoA-1 to be the strongest predictor. Attenuation of prediction ability between nonfatal and fatal AMI may be due to modern treatment of CHD after a NFAMI and attenuation of hazard ratios after 1997 may be due to selection of lower risk subjects surviving to 1997. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/18298486/Relationships_between_lipoprotein_components_and_risk_of_myocardial_infarction:_age_gender_and_short_versus_longer_follow_up_periods_in_the_Apolipoprotein_MOrtality_RISk_study__AMORIS__ DB - PRIME DP - Unbound Medicine ER -