title: Relative importance of different lipid risk factors for the development of myocardial infarction at a very young age (≤ 40 years of age).
abstract: BACKGROUND
  Low-density lipoprotein (LDL) cholesterol lowering has been established as one of the principal targets in preventive cardiology. Recently, assessment of LDL particle size and number as well as other lipid moieties has been presented as a more reliable method to quantify atherogenicity of the lipoprotein fractions. Thus, it was our aim to assess the influence of different lipoprotein fractions on premature myocardial infarction (≤ 40 years of age).
  
  
  RESULTS
  We enrolled 302 patients into our multicentre case-control study, including 102 patients with myocardial infarction and 200 age-, gender- and centre-matched controls. The LDL and HDL Lipoprint System were used for lipid subfraction quantification. The lipid risk factors most strongly associated with premature acute myocardial infarction (AMI) in the adjusted model were non-HDL C (OR 5·02, 95% CI 2·75-9·15, P-value = 0·001), LDL-C (OR 4·35, 95% CI 2·5-7·57, P-value = 0·001), VLDL-C (OR 3·66, 95% CI 2·14-6·28, P-value = 0·001), large IDL-C (OR 3·15, 95% CI 1·94-5·12, P-value = 0·001), large LDL-C (OR 3·67, 95% CI 2·19-6·15, P-value = 0·001) and intermediate LDL-C (OR 1·96, 95% CI 1·25-3·06, P-value = 0·003). In contrast, small dense LDL was not significantly associated with premature myocardial infarction.
  
  
  CONCLUSIONS
  Non-HDL cholesterol is most strongly associated with premature coronary artery disease and could serve as preferred risk predictor and therapeutic target in this young patient population (≤ 40 years). Besides, VLDL, LDL-C, large LDL, intermediate LDL and large IDL were significantly associated with premature myocardial infarction. Furthermore, our data suggest that risk prediction using small dense LDL particles might not be useful in young AMI survivors.
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
authors.forename: Stanislav
authors.initials: S
authors.lastname: Oravec
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Dostal
authors.forename: Matthias
authors.initials: M
authors.lastname: Hoke
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Franz
authors.initials: F
authors.lastname: Wiesbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009203:Myocardial Infarction / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL