Coronary Heart Disease Prediction From Lipoprotein Cholesterol Levels, Triglycerides, Lipoprotein(a), Apolipoproteins A-I and B, and HDL Density Subfractions
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Discussion
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Implication
Cohort study demonstrates that standard lipids and lipoprotein(a) effectively predict heart disease risk in middle-aged adults, indicating that specialized apolipoprotein testing adds little value.
Key Points
- To determine optimal LDL cholesterol levels and evaluate whether adding apolipoproteins or lipid subfractions improves coronary heart disease prediction.
- Followed 12,339 middle-aged participants without baseline coronary heart disease for 10 years in the Atherosclerosis Risk in Communities (ARIC) study.
- Evaluated incident coronary heart disease associations across quintiles of LDL-C, HDL-C, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions.
- Among 725 incident cases, lowest risk occurred at median LDL-C levels of 88 mg/dL in women and 95 mg/dL in men, with highest-quintile relative risks of 2.7 in women and 2.5 in men.
- Independent predictors included LDL-C, HDL-C, lipoprotein(a), and triglycerides (in women only), yielding combined relative risks with traditional risk factors of 13.5 in women and 4.9 in men.
- Risk prediction was not enhanced by HDL-C density subfractions or apolipoproteins A-I and B, even across subgroups with elevated triglycerides or discordant apolipoprotein B levels.
Cite This Study
Sharrett et al. (2001) studied this question.