Differences between markers of atherogenic lipoproteins in predicting high cardiovascular risk and subclinical atherosclerosis in asymptomatic men.
OBJECTIVE
As main markers of atherogenic lipoproteins, apolipoprotein B (apoB), non-HDL cholesterol (non-HDLC), and LDL cholesterol (LDLC) do not seem equipotent to predict cardiovascular complications, we have compared simultaneously their capacity to predict high cardiovascular risk and subclinical atherosclerosis in a primary prevention population.


METHODS
In 723 asymptomatic men, we measured apoB, non-HDLC, and LDLC, and we determined concomitantly coronary heart disease (CHD) risk equivalent defined by National Cholesterol Education Program guidelines, ultrasound-assessed extra-coronary plaques at multiple sites, and electron beam computed tomography-assessed high coronary calcium.


RESULTS
Odds ratios (95% confidence interval) per standard deviation of apoB, non-HDLC, and LDLC of having: (i) CHD risk equivalent were 1.90 (1.53-2.37), 1.78 (1.43-2.21), 1.47 (1.19-1.81); (ii) extra-coronary plaques were 1.37 (1.16-1.61), 1.31 (1.11-1.56), 1.19 (1.01-1.39); (iii) high coronary calcium were 1.35 (1.09-1.68), 1.33 (1.07-1.64), 1.26 (1.01-1.39), respectively. Risk factors and treatment did not confound the above associations, except triglycerides for which adjustment weakened the risk predictions of lipids and annihilated lipids differences in predicting CHD risk equivalent and atherosclerosis markers.


CONCLUSIONS
ApoB was the best predictor, non-HDLC the second best predictor, and LDLC the poorest predictor of high cardiovascular risk and subclinical extra-coronary and coronary atherosclerosis, and triglycerides participated to these differences.
Simon
Alain
A
Centre de Médecine Préventive Cardiovasculaire, Hôpital Broussais, 96 Rue Didot, Assistance Publique-Hôpitaux de Paris, Université Paris V, UMR CNRS 7131, Paris Cedex 14 75674, France. alain.simon@brs.ap-hop-paris.fr
Chironi
Gilles
G
Gariepy
Jerome
J
Del Pino
Muriel
M
Levenson
Jaime
J
D000328:Adult; D001055:Apolipoproteins B / Q000097:blood*; D001161:Arteriosclerosis / Q000097:blood / Q000209:etiology*; D015415:Biomarkers / Q000032:analysis*; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity
D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL