Serum HDL cholesterol <1.09 mmol/l was associated with a 3.3-fold increased risk of acute myocardial infarction (HR 3.3; 95% CI 1.7-6.4) in eastern Finnish men.
Cohort (n=1,799)
Do low serum concentrations of HDL, HDL2, and HDL3 cholesterol increase the risk of acute myocardial infarction in middle-aged men?
Low levels of total HDL and HDL2 cholesterol are strongly associated with an increased risk of acute myocardial infarction, supporting their protective role in ischemic heart disease.
Hazard Ratio: 3.3 (95% CI 1.7–6.4)
BACKGROUND: We investigated the association of cholesterol concentrations in serum high density lipoprotein (HDL) and its subfractions HDL2 and HDL3 with the risk of acute myocardial infarction in 1,799 randomly selected men 42, 48, 54, or 60 years old. METHODS AND RESULTS: Baseline examinations in the Kuopio Ischaemic Heart Disease Risk Factor Study were done during 1984-1987. In Cox multivariate survival models adjusted for age and examination year, serum HDL cholesterol of less than 1.09 mmol/l (42 mg/dl) was associated with a 3.3-fold risk of acute myocardial infarction (95% confidence intervals CI, 1.7-6.4), serum HDL2, cholesterol of less than 0.65 mmol/l (25 mg/dl) was associated with a 4.0-fold risk of acute myocardial infarction (95% CI, 1.9-8.3), and serum HDL3 cholesterol of less than 0.40 mmol/l (15 mg/dl) was associated with a 2.0-fold (95% CI, 1.1-4.0) risk of acute myocardial infarction. Adjustments for obesity, ischemic heart disease, other cardiovascular disease, maximal oxygen uptake, systolic blood pressure, antihypertensive medication, serum low density lipoprotein cholesterol, and triglyceride concentrations reduced the excess risks associated with serum HDL, HDL2, and HDL3 cholesterol in the lowest quartiles by 52%, 48%, and 41%, respectively. Additional adjustments for alcohol consumption, cigarettes smoked daily, smoking years, and leisure time energy expenditure reduced these excess risks associated with low HDL, HDL2, and HDL3 cholesterol levels by another 26%, 24% and 21%, respectively. CONCLUSIONS: Our data confirm that both total HDL and HDL2 levels have inverse associations with the risk of acute myocardial infarction and may thus be protective factors in ischemic heart disease, whereas the role of HDL3 remains equivocal.
Salonen et al. (Mon,) conducted a cohort in Acute myocardial infarction (n=1,799). Low serum HDL cholesterol (<1.09 mmol/l) vs. Higher serum HDL cholesterol was evaluated on Acute myocardial infarction (HR 3.3, 95% CI 1.7-6.4). Serum HDL cholesterol <1.09 mmol/l was associated with a 3.3-fold increased risk of acute myocardial infarction (HR 3.3; 95% CI 1.7-6.4) in eastern Finnish men.