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di Angelantonio, E.* ; Sarwar, N.* ; Perry, P.* ; Kaptoge, S.* ; Ray, K.K.* ; Thompson, A.* ; Wood, A.M.* ; Lewington, S.* ; Sattar, N.* ; Packard, C.J.* ; Collins, R.* ; Thompson, S.G.* ; Tipping, R.W.* ; Ford, C.E.* ; Pressel, S.L.* ; Walldius, G.* ; Jungner, I.* ; Folsom, A.R.* ; Chambless, L.E.* ; Panagiotakos, D.B.* ; Pitsavos, C.* ; Chrysohoou, C.* ; Stefanadis, C.* ; Knuiman, M.* ; Goldbourt, U.* ; Benderly, M.* ; Tanne, D.* ; Whincup, P.H.* ; Wannamethee, S.G.* ; Morris, R.W.* ; Kiechl, S.* ; Willeit, J.* ; Santer, P.* ; Mayr, A.* ; Wald, N.* ; Ebrahim, S.* ; Lawlor, D.A.* ; Yarnell, J.W.* ; Gallacher, J.* ; Casiglia, E.* ; Tikhonoff, V.* ; Nietert, P.J.* ; Sutherland, S.E.* ; Bachman, D.L.* ; Keil, J.E.* ; Cushman, M.* ; Psaty, B.M.* ; Tracy, R.P.* ; Tybjaerg-Hansen, A.* ; Nordestgaard, B.G.* ; Benn, M.* ; Frikke-Schmidt, R.* ; Giampaoli, S.* ; Palmieri, L.* ; Panico, S.* ; Vanuzzo, D.* ; Pilotto, L.* ; Gómez de la Cámara, A.* ; Gómez-Gerique, J.A.* ; Simons, L.* ; McCallum, J.* ; Friedlander, Y.* ; Fowkes, F.G.* ; Lee, A.J.* ; Smith, F.B.* ; Taylor, J.* ; Guralnik, J.M.* ; Phillips, C.L.* ; Wallace, R.* ; Guralnik, J.* ; Blazer, D.G.* ; Khaw, K.T.* ; Brenner, H.* ; Raum, E.* ; Müller, H.* ; Rothenbacher, D.* ; Jansson, J.H.* ; Wennberg, P.* ; Nissinen, A.* ; Donfrancesco, C.* ; Salomaa, V.* ; Harald, K.* ; Jousilahti, P.* ; Vartiainen, E.* ; Woodward, M.* ; D'Agostino, R.B.* ; Wolf, P.A.* ; Vasan, R.S.* ; Pencina, M.J.* ; Bladbjerg, E.M.* ; Jørgensen, T.* ; Møller, L.* ; Jespersen, J.* ; Dankner, R.* ; Chetrit, A.* ; Lubin, F.* ; Rosengren, A.* ; Wilhelmsen, L.* ; Lappas, G.* ; Eriksson, H.* ; Björkelund, C.* ; Lissner, L.* ; Bengtsson, C.* ; Cremer, P.* ; Nagel, D.* ; Tilvis, R.S.* ; Strandberg, T.E.* ; Rodriguez, B.* ; Dekker, J.M.* ; Nijpels, G.* ; Stehouwer, C.D.* ; Rimm, E.* ; Pai, J.K.* ; Sato, S.* ; Iso, H.* ; Kitamura, A.* ; Noda, H.* ; Salonen, J.T.* ; Nyyssönen, K.* ; Tuomainen, T.P.* ; Deeg, D.J.* ; Poppelaars, J.L.* ; Cooper, J.A.* ; Hedblad, B.* ; Berglund, G.* ; Engström, G.* ; Verschuren, W.M.* ; Döring, A. ; Koenig, W.* ; Meisinger, C. ; Mraz, W.* ; Verschure, W.M.* ; Blokstra, A.* ; Bas, Bueno-de-Mesquita, H.* ; Kuller, L.H.* ; Grandits, G.* ; Selmer, R.* ; Tverdal, A.* ; Nystad, W.* ; Gillum, R.* ; Mussolino, M.* ; Hankinson, S.* ; Manson, J.* ; Knottenbelt, C.* ; Bauer, K.A.* ; Naito, Y.* ; Holme, I.* ; Nakagawa, H.* ; Miura, K.* ; Ducimetiere, P.* ; Jouven, X.* ; Crespo, C.J.* ; Garcia Palmieri, M.R.* ; Amouyel, P.* ; Arveiler, D.* ; Evans, A.* ; Ferrieres, J.* ; Schulte, H.* ; Assmann, G.* ; Shepherd, J.* ; Ford, I.* ; Cantin, B.* ; Lamarche, B.* ; Després, J.P.* ; Dagenais, G.R.* ; Barrett-Connor, E.* ; Wingard, D.L.* ; Bettencourt, R.* ; Gudnason, V.* ; Aspelund, T.* ; Sigurdsson, G.* ; Thorsson, B.* ; Trevisan, M.* ; Witteman, J.* ; Kardys, I.* ; Breteler, M.* ; Hofman, A.* ; Tunstall-Pedoe, H.* ; Tavendale, R.* ; Lowe, G.D.* ; Howard, B.V.* ; Zhang, Y.* ; Best, L.* ; Umans, J.* ; Ben-Shlomo, Y.* ; Davey-Smith, G.* ; Onat, A.* ; Njølstad, I.* ; Mathiesen, E.B.* ; Løchen, M.L.* ; Wilsgaard, T.* ; Ingelsson, E.* ; Lind, L.* ; Giedraitis, V.* ; Lannfelt, L.* ; Gaziano, J.M.* ; Stampfer, M.* ; Ridker, P.* ; Ulmer, H.* ; Diem, G.* ; Concin, H.* ; Tosetto, A.* ; Rodeghiero, F.* ; Marmot, M.* ; Clarke, R.* ; Fletcher, A.* ; Brunner, E.* ; Shipley, M.* ; Buring, J.* ; Cobbe, S.M.* ; Robertson, M.* ; He, Y.* ; Marin Ibañez, A.* ; Feskens, E.J.* ; Kromhout, D.* ; Walker, M.* ; Watson, S.* ; Erqou, S.* ; Orfei, L.* ; Pennells, L.* ; Perry, P.L.* ; Alexander, M.* ; Wensley, F.* ; White, I.R.* ; Danesh, J.*

Major lipids, apolipoproteins, and risk of vascular disease.

JAMA 302, 1993-2000 (2009)
DOI PMC
as soon as is submitted to ZB.
CONTEXT: Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified. OBJECTIVE: To assess major lipids and apolipoproteins in vascular risk. DESIGN, SETTING, AND PARTICIPANTS: Individual records were supplied on 302,430 people without initial vascular disease from 68 long-term prospective studies, mostly in Europe and North America. During 2.79 million person-years of follow-up, there were 8857 nonfatal myocardial infarctions, 3928 coronary heart disease [CHD] deaths, 2534 ischemic strokes, 513 hemorrhagic strokes, and 2536 unclassified strokes. MAIN OUTCOME MEASURES: Hazard ratios (HRs), adjusted for several conventional factors, were calculated for 1-SD higher values: 0.52 log(e) triglyceride, 15 mg/dL high-density lipoprotein cholesterol (HDL-C), 43 mg/dL non-HDL-C, 29 mg/dL apolipoprotein AI, 29 mg/dL apolipoprotein B, and 33 mg/dL directly measured low-density lipoprotein cholesterol (LDL-C). Within-study regression analyses were adjusted for within-person variation and combined using meta-analysis. RESULTS: The rates of CHD per 1000 person-years in the bottom and top thirds of baseline lipid distributions, respectively, were 2.6 and 6.2 with triglyceride, 6.4 and 2.4 with HDL-C, and 2.3 and 6.7 with non-HDL-C. Adjusted HRs for CHD were 0.99 (95% CI, 0.94-1.05) with triglyceride, 0.78 (95% CI, 0.74-0.82) with HDL-C, and 1.50 (95% CI, 1.39-1.61) with non-HDL-C. Hazard ratios were at least as strong in participants who did not fast as in those who did. The HR for CHD was 0.35 (95% CI, 0.30-0.42) with a combination of 80 mg/dL lower non-HDL-C and 15 mg/dL higher HDL-C. For the subset with apolipoproteins or directly measured LDL-C, HRs were 1.50 (95% CI, 1.38-1.62) with the ratio non-HDL-C/HDL-C, 1.49 (95% CI, 1.39-1.60) with the ratio apo B/apo AI, 1.42 (95% CI, 1.06-1.91) with non-HDL-C, and 1.38 (95% CI, 1.09-1.73) with directly measured LDL-C. Hazard ratios for ischemic stroke were 1.02 (95% CI, 0.94-1.11) with triglyceride, 0.93 (95% CI, 0.84-1.02) with HDL-C, and 1.12 (95% CI, 1.04-1.20) with non-HDL-C. CONCLUSION: Lipid assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Density-lipoprotein cholesterol; Ischemic-heart-disease; Myocardialinfarction; Nonfasting triglycerides; Cardiovascular-disease; Blodd chloesterol; HDL Cholesterol; Coronary; Metaanalysis; Association
Reviewing status