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Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study.
J Am Coll Cardiol. 2009 Jan 20; 53(3):244-53.JACC

Abstract

OBJECTIVES

This study sought to determine the prevalence of lipid and lipoprotein abnormalities and their association with the risk of a first acute myocardial infarction (AMI) among Asians.

BACKGROUND

Patterns of lipid abnormalities among Asians and their relative impact on cardiovascular risk have not been well characterized.

METHODS

In a case-control study, 65 centers in Asia recruited 5,731 cases of a first AMI and 6,459 control subjects. Plasma levels of lipids and apolipoproteins in the different Asian subgroups (South Asians, Chinese, Southeast Asians, and Japanese) were determined and correlated with the risk of AMI.

RESULTS

Among both cases and controls, mean low-density lipoprotein cholesterol (LDL-C) levels were about 10 mg/dl lower in Asians compared with non-Asians. A greater proportion of Asian cases and controls had LDL-C </=100 mg/dl (25.5% and 32.3% in Asians vs. 19.4% and 25.3% in non-Asians, respectively). High-density lipoprotein cholesterol (HDL-C) levels were slightly lower among Asians compared with non-Asians. There was a preponderance of people with low HDL-C among South Asians (South Asia vs. rest of Asia: cases 82.3% vs. 57.4%; controls 81% vs. 51.6%; p < 0.0001 for both comparisons). However, despite these differences in absolute levels, the risk of AMI associated with increases in LDL-C and decreases in HDL-C was similar for Asians and non-Asians. Among South Asians, changes in apolipoprotein (Apo)A1 predicted risk better than HDL-C. ApoB/ApoA1 showed the strongest association with the risk of AMI.

CONCLUSIONS

The preserved association of LDL-C with risk of AMI among Asians, despite the lower baseline levels, suggests the need to rethink treatment thresholds and targets in this population. The low HDL-C level among South Asians requires further study and targeted intervention.

Authors+Show Affiliations

Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19147041

Citation

Karthikeyan, Ganesan, et al. "Lipid Profile, Plasma Apolipoproteins, and Risk of a First Myocardial Infarction Among Asians: an Analysis From the INTERHEART Study." Journal of the American College of Cardiology, vol. 53, no. 3, 2009, pp. 244-53.
Karthikeyan G, Teo KK, Islam S, et al. Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. J Am Coll Cardiol. 2009;53(3):244-53.
Karthikeyan, G., Teo, K. K., Islam, S., McQueen, M. J., Pais, P., Wang, X., Sato, H., Lang, C. C., Sitthi-Amorn, C., Pandey, M. R., Kazmi, K., Sanderson, J. E., & Yusuf, S. (2009). Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. Journal of the American College of Cardiology, 53(3), 244-53. https://doi.org/10.1016/j.jacc.2008.09.041
Karthikeyan G, et al. Lipid Profile, Plasma Apolipoproteins, and Risk of a First Myocardial Infarction Among Asians: an Analysis From the INTERHEART Study. J Am Coll Cardiol. 2009 Jan 20;53(3):244-53. PubMed PMID: 19147041.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. AU - Karthikeyan,Ganesan, AU - Teo,Koon K, AU - Islam,Shofiqul, AU - McQueen,Mathew J, AU - Pais,Prem, AU - Wang,Xingyu, AU - Sato,Hiroshi, AU - Lang,Chim Choy, AU - Sitthi-Amorn,Chitr, AU - Pandey,M R, AU - Kazmi,Khawar, AU - Sanderson,John E, AU - Yusuf,Salim, PY - 2008/08/11/received PY - 2008/09/16/revised PY - 2008/09/22/accepted PY - 2009/1/17/entrez PY - 2009/1/17/pubmed PY - 2009/2/5/medline SP - 244 EP - 53 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 53 IS - 3 N2 - OBJECTIVES: This study sought to determine the prevalence of lipid and lipoprotein abnormalities and their association with the risk of a first acute myocardial infarction (AMI) among Asians. BACKGROUND: Patterns of lipid abnormalities among Asians and their relative impact on cardiovascular risk have not been well characterized. METHODS: In a case-control study, 65 centers in Asia recruited 5,731 cases of a first AMI and 6,459 control subjects. Plasma levels of lipids and apolipoproteins in the different Asian subgroups (South Asians, Chinese, Southeast Asians, and Japanese) were determined and correlated with the risk of AMI. RESULTS: Among both cases and controls, mean low-density lipoprotein cholesterol (LDL-C) levels were about 10 mg/dl lower in Asians compared with non-Asians. A greater proportion of Asian cases and controls had LDL-C </=100 mg/dl (25.5% and 32.3% in Asians vs. 19.4% and 25.3% in non-Asians, respectively). High-density lipoprotein cholesterol (HDL-C) levels were slightly lower among Asians compared with non-Asians. There was a preponderance of people with low HDL-C among South Asians (South Asia vs. rest of Asia: cases 82.3% vs. 57.4%; controls 81% vs. 51.6%; p < 0.0001 for both comparisons). However, despite these differences in absolute levels, the risk of AMI associated with increases in LDL-C and decreases in HDL-C was similar for Asians and non-Asians. Among South Asians, changes in apolipoprotein (Apo)A1 predicted risk better than HDL-C. ApoB/ApoA1 showed the strongest association with the risk of AMI. CONCLUSIONS: The preserved association of LDL-C with risk of AMI among Asians, despite the lower baseline levels, suggests the need to rethink treatment thresholds and targets in this population. The low HDL-C level among South Asians requires further study and targeted intervention. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/19147041/Lipid_profile_plasma_apolipoproteins_and_risk_of_a_first_myocardial_infarction_among_Asians:_an_analysis_from_the_INTERHEART_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(08)03486-4 DB - PRIME DP - Unbound Medicine ER -