Apolipoproteins A-1 and B and the likelihood of non-fatal stroke and myocardial infarction -- data from The Third National Health and Nutrition Examination Survey.
BACKGROUND
The measurement of plasma apolipoproteins (APO) has been proposed for predicting the risk of cardiovascular diseases. However, the association between APOs and stroke is not well defined.


METHODS
We evaluated the association between plasma concentrations of APO A-1 and APO B with a physician diagnosis of stroke (n=153), and electrocardiogram evidence or physician diagnosis of myocardial infarction (n=379), in a nationally representative sample of 3,696 US adults aged >40 years who participated in the Third National Health and Nutrition Examination Survey. Multivariate logistic regression analyses were used to investigate these relationships.


RESULTS
After adjusting for differences in age, gender, race/ethnicity, education, hypertension, cholesterol, body mass index, and cigarette smoking, the upper quartile of APO A-1 (> or = 161 mg/dl) when compared with the lowest quartile (<126 mg/dL) was inversely associated with the likelihood of myocardial infarction (Odds Ratio [OR], 0.6; 95% Confidence Interval [CI] 0.4-0.9) but not stroke. APO B concentrations were not associated with either myocardial infarction or stroke. However, an APO A-1 to B ratio > or = 1.59 when compared with a ratio < or = 1.04 was associated with a decreased likelihood of myocardial infarction (OR, 0.3; 95% CI, 0.2-0.6); and stroke (OR 0.4, 95% CI, 0.2-1.0).


CONCLUSIONS
Higher APO A-1 concentrations were associated with a decreased likelihood for myocardial infarction but not for stroke. The APO A-1 to B ratio was inversely associated with both myocardial infarction and stroke and may be an important protective clinical marker for atherosclerosis.
Qureshi
Adnan I
AI
Department of Neurosurgery, State University of New York at Buffalo, NY 14209-1194, USA. aiquereshi@hotmail.com
Giles
Wayne H
WH
Croft
Janet B
JB
Guterman
Lee R
LR
Hopkins
L Nelson
LN
D000328:Adult; D000368:Aged; D016632:Apolipoprotein A-I / Q000378:metabolism*; D001055:Apolipoproteins B / Q000378:metabolism*; D001161:Arteriosclerosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000378:metabolism
D016632:Apolipoprotein A-I; D001055:Apolipoproteins B