Low-Density Lipoprotein Subfractions and the Long-Term Risk of Ischemic Heart Disease in Men: 13-Year Follow-Up Data From the Québec Cardiovascular Study
Abstract
OBJECTIVE: The objective of the present study was to investigate the association between large and small low-density lipoprotein (LDL) and long-term ischemic heart disease (IHD) risk in men of the Quebec Cardiovascular Study. METHODS AND RESULTS: Cholesterol levels in the large and small LDL subfractions (termed LDL-C> or =260A and LDL-C<255A, respectively) were estimated from polyacrylamide gradient gel electrophoresis of whole plasma in the cohort of 2072 men of the population-based Quebec Cardiovascular Study. All men were free of IHD at the baseline examination and followed-up for a period of 13 years, during which 262 first IHD events (coronary death, nonfatal myocardial infarction, and unstable angina pectoris) were recorded. Our study confirmed the strong and independent association between LDL-C<255A levels as a proxy of the small dense LDL phenotype and the risk of IHD in men, particularly over the first 7 years of follow-up. However, elevated LDL-C> or =260A levels (third versus first tertile) were not associated with an increased risk of IHD over the 13-year follow-up (RR=0.76; P=0.07). CONCLUSIONS: These results indicated that estimated cholesterol levels in the large LDL subfraction were not associated with an increased risk of IHD in men and that the cardiovascular risk attributable to variations in the LDL size phenotype was largely related to markers of a preferential accumulation of small dense LDL particles.
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Several prospective studies suggest that circulating levels of small, dense LDL particles are better predictors of coronary atherosclerosis, carotid atherosclerosis, and response to therapy than are levels of large, buoyant LDL particles.
“Several prospective studies suggest that circulating levels of small, dense LDL particles are better predictors of coronary atherosclerosis, carotid atherosclerosis, and response to therapy than are levels of large, buoyant LDL particles (28,(31)(32)(33).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [31]
A high small dense LDL level is a risk factor for ASCVD.
“A high small dense LDL level is a risk factor for ASCVD. (Evidence level: E-1a)”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [251]
The association between the levels of small dense LDL and CAD has been reported in numerous sources, and its relationship with PAD and aneurysms has also been demonstrated.
“The association between the levels of small dense LDL and CAD has been reported in numerous sources251–256), and its relationship with PAD and aneurysms has also been demonstrated257, 258).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [251]
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Self-citation
- Authors
- St-Pierre, A. C., Cantin, B., Dagenais, G. R., Mauriège, P., Bernard, P.-M., Després, J.-P., & Lamarche, B.
- Affiliations
- From the Institute on Nutraceuticals and Fonctionnal Foods (A.C.S.-P., B.L.), Laval University; Québec Heart Institute (B.C., G.R.D., J.-P.D.), Laval Hospital; Department of Social and Preventive Medicine (P.M., P.-M.B.), Laval University, Québec, Canada.
- Université Laval (CA)
- Wolters Kluwer Health (US)
- ORCID
- Dagenais, Gilles R.
- Venue
- Arteriosclerosis, Thrombosis, and Vascular Biology
- Published
- 2005-03
- Volume
- 25
- Issue
- 3
- Pages
- 553-559
- ISSN
- 1079-5642 (ISSN-L)
- 1524-4636
- OpenAlex
- W2101333957
- Cited by
- 422
- References
- 20
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 9 · 2023: 14 · 2022: 14 · 2021: 13 · 2020: 12 · 2019: 11 · 2018: 13 · 2017: 14 · 2016: 18 · 2015: 15 · 2014: 17 · 2013: 22 · 2012: 29
- FWCI
- 24.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Heart and Stroke Foundation of Canada
- Canada Research Chairs
- Canadian Institutes of Health Research
- 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
- low-density lipoprotein subfractions, small dense LDL, ischemic heart disease, cardiovascular risk, men, coronary artery disease, myocardial infarction, unstable angina
- MeSH terms
- Adult, Aged, Angina, Unstable, Follow-Up Studies, Humans, Cholesterol, LDL, Male, Middle Aged, Molecular Weight, Myocardial Infarction, Quebec, Risk Factors, Survival Analysis, Death, Sudden, Cardiac, Myocardial Ischemia
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