Serum Low-Density Lipoprotein to High-Density Lipoprotein Ratio as a Predictor of Future Acute Myocardial Infarction Among Men in a 2.7-Year Cohort Study of a Japanese Northern Rural Population
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AIM: To examine and compare the predictive value of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C and LDL-C/HDL-C ratios for future cardiovascular outcomes in the general Japanese population. METHODS: A total of 24,566 eligible participants aged 18 years or older, without cardiovascular disease, were enrolled through multiphase health screening and divided into quartile groups based on lipoprotein levels or ratios. Primary endpoints of the study were definitive acute myocardial infarction (AMI) and ischemic stroke, and cases of sudden death with unknown causes were not included. We used Cox proportional hazard models to examine the relationships between the quartiles and incidences of AMI or ischemic stroke, adjusting for traditional risk factors. RESULTS: Mean age was 63.7 years for males and 60.7 years for females. Mean follow-up period was 2.7 years, and 40 cases of AMI and 182 cases of ischemic stroke were recorded. The hazard ratio (HR) for AMI was significantly higher in the top quartile of the LDL-C/HDL-C ratio and LDL-C levels, and third quartile of TC among male participants. The HR of male participants with a LDL-C/HDL-C ratio of 2.6 or higher was significantly higher than other quartiles. No association between lipoprotein levels or their ratio quartiles and ischemic stroke was seen for either sex after adjusting for risk factors. CONCLUSIONS: Our results indicated that the LDL-C/HDL-C ratio is an independent predictor for AMI, and the importance of better management of cardiovascular risks among people with high LDLC/HDLC ratios for the prevention of future cardiovascular disease.
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The increase in hazard ratio for CAD incidence and mortality following LDL-C elevation has been validated in Japanese cohort studies.
“the increase in hazard ratio for the CAD incidence and mortality following an elevation in LDL-C has been validated in cohort studies involving the Japanese36–40).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [39]
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Correlations between Oxidative Stress and Blood Lipids Are Stronger in Men than Women
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Association between elevated lipoprotein(a) levels and cardiovascular risk
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Statin Therapy Alters the Distribution of the LDL-C/HDL-C Ratio: A Weibull Modeling StudyPreprint
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- Authors
- Yokokawa, H., Yasumura, S., Tanno, K., Ohsawa, M., Onoda, T., Itai, K., Sakata, K., Kawamura, K., Tanaka, F., Yoshida, Y., Nakamura, M., Terayama, Y., Ogawa, A., & Okayama, A.
- Affiliations
- Fukushima Medical University (JP)
- Iwate Medical University (JP)
- Japan Anti Tuberculosis Association (JP)
- ORCID
- Venue
- Journal of Atherosclerosis and Thrombosis
- Publisher
- Japan Atherosclerosis Society
- Published
- 2011
- Volume
- 18
- Issue
- 2
- Pages
- 89-98
- ISSN
- 1340-3478 (ISSN-L)
- 1880-3873
- OpenAlex
- W2055096034
- Cited by
- 83
- References
- 31
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 12 · 2019: 4 · 2018: 10 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 5
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Atherosclerosis and Thrombosis (publishedVersion, cc-by-nc-sa)
- 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
- LDL/HDL ratio, LDL cholesterol, HDL cholesterol, total cholesterol, acute myocardial infarction, ischemic stroke, cardiovascular risk prediction, cardiovascular risk management, men
- MeSH terms
- Adolescent, Adult, Aged, Cholesterol, Female, Humans, Japan, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Risk Factors, Rural Population, Cohort Studies, Proportional Hazards Models, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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