Key result
Elevated total cholesterol-HDL-C ratio and CRP strongly predicted incident peripheral arterial disease (RR 3.9, 95% CI 1.7-8.6 and RR 2.8, 95% CI 1.3-5.9 for highest vs lowest quartiles).
Why the study?
Do elevated levels of novel atherothrombotic biomarkers predict the development of symptomatic peripheral arterial disease in initially healthy men?
Population
280 men drawn from a prospective cohort of 14,916 initially healthy US male physicians aged 40 to 84 years.
Comparison
Measurement of 11 lipid and nonlipid biomarkers… vs Lower levels of the respective biomarkers
Design
Case-control
Follow-up
average 9 years
Authors
Discussion
Loading...
Member takes
Implication
May enhance PAD risk models in men; extends biomarker data but leaves open whether targeting improves outcomes.
Key Points
- To compare the predictive value of lipid and nonlipid biomarkers for symptomatic peripheral arterial disease.
- Nested case-control study using plasma samples from a cohort of 14,916 healthy male physicians aged 40 to 84 years.
- 140 cases of symptomatic peripheral arterial disease matched with 140 controls on age and smoking status.
- Multivariable analyses to assess the predictive power of 11 biomarkers including cholesterol and C-reactive protein.
- Total cholesterol-HDL-C ratio (RR 3.9, 95% CI 1.7-8.6) was the strongest lipid predictor for PAD risk.
- C-reactive protein was the strongest nonlipid predictor (RR 2.8, 95% CI 1.3-5.9).
- Adding C-reactive protein to lipid screening significantly enhanced risk prediction models (P<.001).
Study Design
Type
Case-Control (n=280)
Structured PICO
Do elevated levels of novel atherothrombotic biomarkers predict the development of symptomatic peripheral arterial disease in initially healthy men?
P
Population
280 men (140 cases of incident symptomatic PAD and 140 age- and smoking status-matched controls) drawn from a prospective cohort of 14,916 initially healthy US male physicians aged 40 to 84 years.
I
Intervention
Measurement of 11 lipid and nonlipid biomarkers (total cholesterol, HDL-C, LDL-C, total cholesterol-HDL-C ratio, triglycerides, homocysteine, CRP, lipoprotein(a), fibrinogen, apo A-I, and apo B-100)
C
Comparator
Lower levels (lowest quartile) of the respective biomarkers
O
Outcome
Incident symptomatic peripheral arterial disease (PAD) over an average 9-year follow-uphard clinical
Main Result
Effect estimate: RR 3.9 (95% CI 1.7-8.6)
p-value: p=<.001
The total cholesterol-HDL-C ratio and CRP are strong, independent predictors of incident peripheral arterial disease in initially healthy men, with CRP adding prognostic value to standard lipid screening.
Cite This Study
Ridker et al. (2001) conducted a case-control in Symptomatic peripheral arterial disease (PAD) (n=280). Atherothrombotic biomarkers (total cholesterol-HDL-C ratio and CRP) vs. Lowest quartile of biomarker levels was evaluated on Incident symptomatic peripheral arterial disease (RR 3.9, 95% CI 1.7-8.6, p=<.001). Elevated total cholesterol-HDL-C ratio and CRP strongly predicted incident peripheral arterial disease (RR 3.9, 95% CI 1.7-8.6 and RR 2.8, 95% CI 1.3-5.9 for highest vs lowest quartiles).