July 19, 2005JAMA
Non–HDL Cholesterol, Apolipoproteins A-I and B100, Standard Lipid Measures, Lipid Ratios, and CRP as Risk Factors for Cardiovascular Disease in Women
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Discussion
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Implication
Prospective cohort study finds non-HDL cholesterol, lipid ratios, and C-reactive protein strongly predict cardiovascular risk in women, highlighting their clinical value over standard LDL measures.
Key Points
- To directly evaluate and compare standard lipid measures, non-HDL cholesterol, apolipoproteins, lipid ratios, and high-sensitivity C-reactive protein as predictors of future cardiovascular events in women.
- Prospective cohort study of 15,632 initially healthy US women aged 45 years or older followed over a 10-year period between 1992 and 1995.
- Assessed baseline levels of total cholesterol, LDL-C, HDL-C, non-HDL-C, apolipoproteins A-I and B100, hs-CRP, and various lipid ratios.
- Calculated multivariable-adjusted hazard ratios for first-ever major cardiovascular events (N = 464) across extreme quintiles, controlling for age, smoking status, blood pressure, diabetes, and BMI.
- Adjusted HRs for extreme quintiles of single biomarkers were 1.62 (95% CI, 1.17–2.25) for LDL-C, 2.50 (95% CI, 1.68–3.72) for apolipoprotein B100, 2.51 (95% CI, 1.69–3.72) for non-HDL-C, and 2.98 (95% CI, 1.90–4.67) for hs-CRP (P < .001 for trend).
- Lipid ratios demonstrated the strongest risk associations, reaching an adjusted HR of 3.81 (95% CI, 2.47–5.86) for total cholesterol to HDL-C and 3.56 (95% CI, 2.31–5.47) for apolipoprotein B100 to HDL-C (P < .001 for trend).
- Cut points for hs-CRP (<1, 1–3, and >3 mg/L) supplied additional prognostic risk information across every level of all evaluated lipid measures and ratios.
Cite This Study
Ridker et al. (2005) studied this question.