Cited by 239Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCholesterol and Lipid Metabolism

Value of Low-Density Lipoprotein Particle Number and Size as Predictors of Coronary Artery Disease in Apparently Healthy Men and Women

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El Harchaoui, Karim, van der Steeg, Wim A., Stroes, Erik S.G., Kuivenhoven, Jan Albert, Otvos, James D., Wareham, Nicholas J., Hutten, Barbara A., Kastelein, John J.P. +2 more·2007·Journal of the American College of Cardiology

Abstract

Objectives We assessed relations of low-density lipoprotein (LDL) particle number (LDL-P) and LDL particle size as measured by nuclear magnetic resonance spectroscopy with LDL cholesterol (LDL-C) and the risk of future coronary artery disease (CAD).Background Whereas LDL-C is an established risk factor for CAD, its discriminative power is limited. Measuring LDL-P and size may have stronger associations with CAD than LDL-C.Methods A nested case-control study was performed in the prospective EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk study, which comprises 25,663 subjects. Cases (n = 1,003) were individuals who developed CAD during 6 year follow-up. Control subjects (n = 1,885) were matched for age, gender, and enrollment time. Odds ratios (ORs) for future CAD were calculated, and we also evaluated whether LDL-P could improve the Framingham risk score (FRS) to predict CAD.Results In univariate analyses, LDL-P (OR 2.00, 95% confidence interval [CI] 1.58 to 2.59) and non-high-density lipoprotein cholesterol (non-HDL-C) (OR 2.14, 95% CI 1.69 to 2.69) were more closely associated with CAD than LDL-C (OR 1.73, 95% CI 1.37 to 2.18). The additional value of LDL-P was lost after adjustment for HDL-C and triglyceride levels. Whereas LDL size was inversely related to CAD (OR 0.60, 95% CI 0.47 to 0.76), this relation was abolished upon adjustment for LDL-P. In a model adjusted for the FRS, LDL-P retained its association with CAD (p for trend 0.02).Conclusions In this large study of individuals with moderately elevated LDL-C, LDL-P was related to CAD on top of FRS as well as after adjusting for LDL-C. The additional value of LDL-P was comparable to non-HDL-C, and it was abolished after adjusting for triglycerides and HDL-C.

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Crossref · 10.1016/j.jacc.2006.09.043

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Authors
El Harchaoui, K., van der Steeg, W. A., Stroes, E. S. G., Kuivenhoven, J. A., Otvos, J. D., Wareham, N. J., Hutten, B. A., Kastelein, J. J. P., Khaw, K.-T., & Boekholdt, S. M.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • MRC Epidemiology Unit (GB)
  • University of Cambridge (GB)
Corresponding author
Kastelein, John J.P.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2007-02
Volume
49
Issue
5
Pages
547-553
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2109806543
Cited by
239
References
27
Citations by year
2026: 2 · 2025: 6 · 2024: 2 · 2023: 6 · 2022: 8 · 2021: 6 · 2020: 10 · 2019: 6 · 2018: 11 · 2017: 14 · 2016: 12 · 2015: 12 · 2014: 18 · 2013: 14 · 2012: 11
FWCI
27.29
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Wellcome Trust
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
Keywords
LDL particle size, coronary artery disease, LDL cholesterol, non-HDL cholesterol, cardiovascular risk prediction, Framingham risk score, triglycerides, HDL cholesterol, EPIC-Norfolk cohort
MeSH terms
Aged, Cholesterol, Coronary Artery Disease, Female, Humans, Lipoproteins, LDL, Male, Middle Aged, Magnetic Resonance Spectroscopy, Particle Size, Risk Factors, Triglycerides, Cohort Studies, Biomarkers, Case-Control Studies

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