Relative contribution of lipids and apolipoproteins to incident coronary heart disease and ischemic stroke: the PRIME Study.
OBJECTIVE
To compare within the same cohort the association of a large panel of lipids with the risk of incident coronary heart disease (CHD) and ischemic stroke events in participants of the Prospective Epidemiological Study of Myocardial Infarction.


METHODS
In this binational (Northern Ireland and France) prospective cohort, we considered 9,711 men aged 50-59 years free of CHD and stroke at baseline (1991-1993). The hazard ratios of each lipid marker for CHD and ischemic stroke events were estimated in separate Cox proportional hazard models adjusted for age, study center, systolic blood pressure, antihypertensive treatment, current smoking status, body mass index and diabetes.


RESULTS
After 10 years of follow-up, 635 men had a first CHD and 98 a first ischemic stroke event. Total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, triglycerides, apolipoprotein (Apo) A1 and Apo B100, their ratios and lipoprotein (a) [Lp(a)] were all significantly predictive of future CHD. Associations with ischemic stroke followed the same trend as for CHD, but with lower strength, and none were statistically significant. However, none of the differences between the hazard ratios for CHD and for ischemic stroke were statistically significant.


CONCLUSIONS
In healthy, middle-aged men, total-C, HDL-C, LDL-C, non-HDL-C, triglycerides, Apo A1 and Apo B100, their ratios and Lp(a) are, if anything, weak predictors of ischemic stroke events over a 10-year period.
Canouï-Poitrine
Florence
F
INSERM, U970, Paris Cardiovascular Research Center, Université Paris Descartes, UMR-S970, Paris, France.
Luc
Gerald
G
Bard
Jean-Marie
JM
Ferrieres
Jean
J
Yarnell
John
J
Arveiler
Dominique
D
Morange
Pierre
P
Kee
Frank
F
Evans
Alun
A
Amouyel
Philippe
P
Ducimetiere
Pierre
P
Empana
Jean-Philippe
JP
D016632:Apolipoprotein A-I / Q000097:blood; D053299:Apolipoprotein B-100 / Q000097:blood; D001053:Apolipoproteins / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology*; D005602:France / Q000453:epidemiology; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000453:epidemiology*; D014280:Triglycerides / Q000097:blood
D016632:Apolipoprotein A-I; D053299:Apolipoprotein B-100; D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol