Increased plasma apolipoprotein C-III concentration independently predicts cardiovascular mortality: the Hoorn Study.
BACKGROUND
Hypertriglyceridemia is a cardiovascular risk factor. Apolipoprotein C-III (apoC-III) is an important determinant of the catabolic rate of triglyceride-rich lipoproteins. The aim of this study was to investigate the prognostic value of plasma apoC-III concentrations for cardiovascular mortality.


METHODS
We performed this prospective study in 2244 subjects (ages 49-77 years) who participated in the Hoorn Study. During a mean follow-up of 15 years, 504 individuals died: 231 of cardiovascular disease, 180 of cancer, and 93 of other causes. Cardiovascular disease risk factors and plasma apoC-III concentrations were measured at baseline.


RESULTS
The age- and sex-adjusted plasma apoC-III concentration was prospectively associated with cardiovascular mortality (P < 0.001). After adjustment for traditional risk factors, including fasting triglycerides, the hazard ratio (95% CI) for cardiovascular death between the highest and the lowest quartile of apoC-III was 1.85 (1.02-3.38). High concentrations of apoC-III did not appear to be associated with noncardiovascular mortality.


CONCLUSIONS
In this general population cohort, a high apoC-III concentration in plasma, independently of fasting triglycerides and other traditional risk factors, predicts cardiovascular mortality.
Metabolic Laboratory, Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands. p.scheffer@vumc.nl
Peter G
PG
Scheffer
Tom
T
Teerlink
Jacqueline M
JM
Dekker
Griët
G
Bos
Giel
G
Nijpels
Michaela
M
Diamant
Piet J
PJ
Kostense
Coen D A
CD
Stehouwer
Robert J
RJ
Heine
D000368:Aged; D053305:Apolipoprotein C-III / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000378:metabolism / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies
D053305:Apolipoprotein C-III; D005947:Glucose