title: Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS).
abstract: OBJECTIVE
  Examine and compare lipoprotein components associated with fatal and nonfatal acute myocardial infarction (AMI) by time period in the Apolipoprotein MOrtality RISk (AMORIS) Study.
  
  
  METHODS
  Prospective follow-up study of nonfatal and fatal myocardial infarction through linkage with Swedish hospital discharge and Swedish mortality registers.
  
  
  METHODS
  Measurements of lipoprotein components from health check-ups in the larger Stockholm area.
  
  
  METHODS
  The AMORIS subjects (n = 149 121) free of AMI at blood sampling were followed from 1985 to 2002 with respect to n = 6794 first cases of AMI.
  
  
  RESULTS
  Hazard ratios of nonfatal and fatal AMI by lipoprotein parameters were highly significant and about equally strong in both genders. Apolipoprotein B (apoB), nonhigh density cholesterol and low density cholesterol predicted nonfatal AMI (NFAMI) better than fatal AMI, but high density cholesterol or apolipoprotein A-1 did not. Atherogenic components were weaker predictors after 1997 than before. In multivariate analyses apoB/apoA-1 was a better predictor than TC/HDL-C. ApoB/apoA-1 added clinically significant information to TC/HDL-C in men as reflected by a net reclassification improvement (NRI) of 9.4% (P < 0.0001).
  
  
  CONCLUSIONS
  ApoB, apoB/apoA-1 and non-HDL-C were found about equally predictive with LDL-C being slightly less, but multivariate analyses showed apoB/apoA-1 to be the strongest predictor. Attenuation of prediction ability between nonfatal and fatal AMI may be due to modern treatment of CHD after a NFAMI and attenuation of hazard ratios after 1997 may be due to selection of lower risk subjects surviving to 1997.
authors.affiliation: Department of Preventive Cardiology, Centre of Preventive Medicine, Ulleval University Hospital, Oslo, Norway. ingar.holme@uus.no
authors.forename: I
authors.initials: I
authors.lastname: Holme
authors.forename: A H
authors.initials: AH
authors.lastname: Aastveit
authors.forename: I
authors.initials: I
authors.lastname: Jungner
authors.forename: G
authors.initials: G
authors.lastname: Walldius
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood*; D001055:Apolipoproteins B / Q000097:blood*; D002784:Cholesterol / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D002784:Cholesterol