Serum Total and Non-High-Density Lipoprotein Cholesterol and the Risk Prediction of Cardiovascular Events: – The JALS-ECC –

Tanabe, Naohito; Iso, Hiroyasu; Okada, Katsutoshi; Nakamura, Yasuyuki; Harada, Akiko; Ohashi, Yasuo; Ando, Takashi; Ueshima, Hirotsugu; The Japan Arteriosclerosis Longitudinal Study Group

doi:10.1253/circj.cj-09-0861

Cited by 99Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Health and Risk Factors

Serum Total and Non-High-Density Lipoprotein Cholesterol and the Risk Prediction of Cardiovascular Events: – The JALS-ECC –

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Tanabe, Naohito, Iso, Hiroyasu, Okada, Katsutoshi, Nakamura, Yasuyuki, Harada, Akiko, Ohashi, Yasuo, Ando, Takashi, Ueshima, Hirotsugu +1 more·2010·Circulation Journal

DOI 10.1253/circj.cj-09-0861

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Abstract

BACKGROUND: Few Japanese studies have compared serum non-high-density lipoprotein (non-HDL) cholesterol with serum total cholesterol as factors for predicting risk of cardiovascular events. Currently, few tools accurately estimate the probability of developing cardiovascular events for the Japanese general population. METHODS AND RESULTS: A total of 22,430 Japanese men and women (aged 40-89 years) without a history of cardiovascular events from 10 community-based cohorts were followed. In an average 7.6-year follow up, 104 individuals experienced acute myocardial infarction (AMI) and 339 experienced stroke. Compared to serum total cholesterol, serum non-HDL cholesterol was more strongly associated with risk of AMI in a dose-response manner (multivariable adjusted incidence rate ratio per 1 SD increment [95% confidence interval] =1.49 [1.24-1.79] and 1.62 [1.35-1.95], respectively). Scoring systems were constructed based on multivariable Poisson regression models for predicting a 5-year probability of developing AMI; the non-HDL cholesterol model was found to have a better predictive ability (area under the receiver operating curve [AUC] =0.825) than the total cholesterol model (AUC =0.815). Neither total nor non-HDL serum cholesterol levels were associated with any stroke subtype. CONCLUSIONS: The risk of AMI can be more reliably predicted by serum non-HDL cholesterol than serum total cholesterol. The scoring systems are useful tools to predict risk of AMI. Neither total nor non-HDL serum cholesterol can predict stroke risk in the Japanese general population.

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Japanese cohort studies reported an increase in CAD incidence and mortality following TC elevation.
“a number of cohort studies conducted in Japan have reported an increase in the incidence and mortality rates of CAD following an elevation in TC level48–54).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [51]
Non-HDL-C is associated with CAD in many Japanese epidemiological surveys.
“The association between non-HDL-C and CAD has been reported in the results of many epidemiological surveys conducted in Japan51, 63–70).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [51]
Non-HDL-C surpasses TC in the ability to predict myocardial infarction occurrence.
“non-HDL-C surpasses TC in the ability to predict the occurrence of MI51).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [51]
There are several assessment tools that predict the absolute risk of ASCVD in the Japanese population.
“There are several assessment tool that predict the absolute risk of ASCVD in the Japanese population.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [336]

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Brachial intima-media thickness is associated with coronary artery atherosclerosis in patients with diabetes mellitus
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Risk factors for ischemic heart disease in males in the prime of life: An eight-year follow-up study
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A study of the relationship between brachial artery vasodilation and platelet/lymphocyte ratio in diabetic patients with coronary atherosclerosis
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Antioxidant Vitamin Intake and LOX-Index in Japanese Municipal Workers
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Authors: Tanabe, N., Iso, H., Okada, K., Nakamura, Y., Harada, A., Ohashi, Y., Ando, T., Ueshima, H., & The Japan Arteriosclerosis Longitudinal Study Group
Affiliations: Niigata University (JP)
The University of Osaka (JP)
Ehime University (JP)
Kyoto Women's University (JP)
Chiba Prefectural Institute of Public Health (JP)
The University of Tokyo (JP)
Lund University (SE)
Shiga University of Medical Science (JP)
ORCID: Iso, Hiroyasu
Nakamura, Yasuyuki
Harada, Akiko
Ohashi, Yasuo
Ando, Takashi
Ueshima, Hirotsugu
Venue: Circulation Journal
Publisher: Japanese Circulation Society
Published: 2010
Volume: 74
Issue: 7
Pages: 1346-1356
ISSN: 1346-9843 (ISSN-L)
1347-4820
DOI: 10.1253/circj.cj-09-0861
OpenAlex: W2075970369
Cited by: 99
References: 59
Citations by year: 2026: 2 · 2025: 3 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 5 · 2018: 5 · 2017: 4 · 2016: 7 · 2015: 11 · 2014: 10 · 2013: 12 · 2012: 6
FWCI: 7.75
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation Journal (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords: non-HDL cholesterol, total cholesterol, acute myocardial infarction, stroke, cardiovascular risk prediction, risk scoring, Japanese population, community-based cohort, lipid biomarkers
MeSH terms: Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Cholesterol, Female, Follow-Up Studies, Humans, Japan, Male, Middle Aged, Myocardial Infarction, Predictive Value of Tests, Risk, Incidence, Area Under Curve, Stroke

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