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)
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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.
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Emerging evidence suggested the apoB:apoA1 ratio to be the best overall predictor of CVD risk compared with other lipid markers.
“Emerging evidence suggested the apoB:apoA1 ratio to be the best overall predictor of CVD risk compared with other lipid markers (44, 47, 48).”
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- Authors
- Holme, I., Aastveit, A. H., Jungner, I., & Walldius, G.
- Affiliations
- Oslo University Hospital (NO)
- Norwegian University of Life Sciences (NO)
- Karolinska Institutet (SE)
- Corresponding author
- Holme, I.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 2008-06-28
- Volume
- 264
- Issue
- 1
- Pages
- 30-38
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W1999515845
- Cited by
- 106
- References
- 38
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 11 · 2020: 6 · 2019: 2 · 2018: 4 · 2017: 8 · 2016: 5 · 2015: 6 · 2014: 3 · 2013: 5 · 2012: 4
- FWCI
- 13.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fondation pour la Médecine de Laboratoire
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- acute myocardial infarction, apolipoprotein B, apolipoprotein A-I, non-HDL cholesterol, LDL cholesterol, HDL cholesterol, coronary heart disease risk prediction, net reclassification improvement, age and gender differences, follow-up duration
- MeSH terms
- Adult, Age Factors, Aged, Aged, 80 and over, Apolipoproteins B, Cholesterol, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Myocardial Infarction, Sex Factors, Sweden, Apolipoprotein A-I
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