Use of lipoprotein particle measures for assessing coronary heart disease risk post-American Heart Association/American College of Cardiology Guidelines: The multi-ethnic study of atherosclerosis

Brian T. Steffen, Weihua Guan, Alan T. Remaley, Pathmaja Paramsothy, Susan R. Heckbert, Robyn L. McClelland, Philip Greenland, Erin Donnelly Michos, Michael Y. Tsai

Research output: Contribution to journalArticle

Abstract

OBJECTIVE - : The American College of Cardiology and American Heart Association have issued guidelines indicating that the contribution of apolipoprotein B-100 (ApoB) to cardiovascular risk assessment remains uncertain. The present analysis evaluates whether lipoprotein particle measures convey risk of coronary heart disease (CHD) in 4679 Multi-Ethnic Study of Atherosclerosis (MESA) participants. APPROACH AND RESULTS - : Cox regression analysis was performed to determine associations between lipids or lipoproteins and primary CHD events. After adjustment for nonlipid variables, lipoprotein particle levels in fourth quartiles were found to convey significantly greater risk of incident CHD when compared to first quartile levels (hazard ratio [HR]; 95% confidence interval [CI]): ApoB (HR, 1.84; 95% CI, 1.25-2.69), ApoB/ApoA-I (HR, 1.91; 95% CI, 1.32-2.76), total low-density lipoprotein-particles (LDL-P; HR, 1.77; 95% CI, 1.21-2.58), and the LDL-P/HDL-P (high-density lipoprotein-P) ratio (HR, 2.28; 95% CI, 1.54-3.37). Associations between lipoprotein particle measures and CHD were attenuated after adjustment for standard lipid panel variables. Using the American Heart Association/American College of Cardiology risk calculator as a baseline model for CHD risk assessment, significant net reclassification improvement scores were found for ApoB/ApoA-I (0.18; P=0.007) and LDL-P/high-density lipoprotein-P (0.15; P

Original languageEnglish (US)
Pages (from-to)448-454
Number of pages7
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume35
Issue number2
DOIs
StatePublished - Feb 2 2015

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Apolipoprotein B-100
Lipoproteins
Coronary Disease
Atherosclerosis
Guidelines
Confidence Intervals
Apolipoprotein A-I
HDL Lipoproteins
Lipids
LDL Lipoproteins
Regression Analysis
oxidized low density lipoprotein

Keywords

  • apolipoproteins
  • coronary disease
  • lipids
  • lipoproteins
  • magnetic resonance spectroscopy
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Use of lipoprotein particle measures for assessing coronary heart disease risk post-American Heart Association/American College of Cardiology Guidelines : The multi-ethnic study of atherosclerosis. / Steffen, Brian T.; Guan, Weihua; Remaley, Alan T.; Paramsothy, Pathmaja; Heckbert, Susan R.; McClelland, Robyn L.; Greenland, Philip; Michos, Erin Donnelly; Tsai, Michael Y.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 35, No. 2, 02.02.2015, p. 448-454.

Research output: Contribution to journalArticle

Steffen, Brian T. ; Guan, Weihua ; Remaley, Alan T. ; Paramsothy, Pathmaja ; Heckbert, Susan R. ; McClelland, Robyn L. ; Greenland, Philip ; Michos, Erin Donnelly ; Tsai, Michael Y. / Use of lipoprotein particle measures for assessing coronary heart disease risk post-American Heart Association/American College of Cardiology Guidelines : The multi-ethnic study of atherosclerosis. In: Arteriosclerosis, Thrombosis, and Vascular Biology. 2015 ; Vol. 35, No. 2. pp. 448-454.
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AU - Remaley, Alan T.

AU - Paramsothy, Pathmaja

AU - Heckbert, Susan R.

AU - McClelland, Robyn L.

AU - Greenland, Philip

AU - Michos, Erin Donnelly

AU - Tsai, Michael Y.

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