Value of HDL cholesterol, apolipoprotein A-I, lipoprotein A-I, and lipoprotein A-I/A-II in prediction of coronary heart disease: the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction.
OBJECTIVE
We have examined the association between the incidence of coronary heart disease (CHD) and plasma high density lipoprotein (HDL) cholesterol, apolipoprotein A-I (apoA-I), and 2 HDL fractions, lipoprotein A-I and lipoprotein A-I:A-II.


RESULTS
These parameters were measured in subjects recruited in France and in Northern Ireland in the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study, a prospective cohort study. Among the subjects free of CHD on entry, 176 in France and 113 in Northern Ireland suffered an ischemic attack (CHD patients) during the 5-year follow-up, whereas 6612 French and 2172 Northern Irish men showed no CHD symptoms (CHD-free subjects). All 4 HDL parameter levels were lower in CHD patients than in CHD-free subjects. After the cohort was divided into quintiles based on the distribution of HDL parameter levels, a significant (P<0.0001) linear increase in relative risk was observed for each HDL parameter level. However, regression logistic analyses showed that apoA-I was the strongest predictor (more powerful than HDL cholesterol) and that lipoprotein A-I and lipoprotein A-I:A-II did not supplement apoA-I in predicting CHD.


CONCLUSIONS
Among the parameters related to HDL, apoA-I appears to be the strongest independent risk factor.
Department of Atherosclerosis, INSERM UR545, Institut Pasteur de Lille, and University Lille II, Lille, France. Gerald.Luc@pasteur-lille.fr
Gérald
G
Luc
Jean-Marie
JM
Bard
Jean
J
Ferrières
Alun
A
Evans
Philippe
P
Amouyel
Dominique
D
Arveiler
Jean-Charles
JC
Fruchart
Pierre
P
Ducimetière
D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D016632:Apolipoprotein A-I / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006801:Humans; D017270:Lipoprotein(a) / Q000031:analogs & derivatives* / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology; D009660:Northern Ireland / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL; D017270:Lipoprotein(a); C106575:lipoprotein A-II; C078260:lipoprotein A-I