title: Relationship of lipid oxidation with subclinical atherosclerosis and 10-year coronary events in general population.
abstract: OBJECTIVE
  To assess 1) the association of lipid oxidation biomarkers with 10-year coronary artery disease (CAD) events and subclinical atherosclerosis, and 2) the reclassification capacity of these biomarkers over Framingham-derived CAD risk functions, in a general population.
  
  
  METHODS
  Within the framework of the REGICOR study, 4782 individuals aged between 25 and 74 years were recruited in a population-based cohort study. Follow-up of the 4042 who met the eligibility criteria was carried out. Plasma, circulating oxidized low-density lipoprotein (oxLDL) and oxLDL antibodies (OLAB) were measured in a random sample of 2793 participants. End-points included fatal and non-fatal acute myocardial infarction (AMI) and angina. Carotid intima-media thickness (IMT) in the highest quintile and ankle-brachial index <0.9 were considered indicators of subclinical atherosclerosis.
  
  
  RESULTS
  Mean age was 50.0 (13.4) years, and 52.4% were women. There were 103 CAD events (34 myocardial infarction, 43 angina, 26 coronary deaths), and 306 subclinical atherosclerosis cases. Oxidized LDL was independently associated with higher incidence of CAD events (HR = 1.70; 95% Confidence Interval: 1.02-2.84), but not with subclinical atherosclerosis. The net classification index of the Framingham-derived CAD risk function was significantly improved when ox-LDL was included (NRI = 14.67% [4.90; 24.45], P = 0.003). No associations were found between OLAB and clinical or subclinical events. The reference values for oxLDL and OLAB are also provided (percentiles).
  
  
  CONCLUSIONS
  OxLDL was independently associated with 10-year CAD events but not subclinical atherosclerosis in a general population, and improved the reclassification capacity of Framingham-derived CAD risk functions.
authors.affiliation: Cardiology Department, Parc de Salut Mar, Barcelona, Spain; Medicine Department, Autonomous University of Barcelona, Barcelona, Spain; Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Gómez
authors.affiliation: Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular and Genetic Epidemiology Research Group (EGEC, REGICOR Study Group), IMIM, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Vila
authors.affiliation: Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular and Genetic Epidemiology Research Group (EGEC, REGICOR Study Group), IMIM, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
authors.affiliation: Cardiology Department, Parc de Salut Mar, Barcelona, Spain; Medicine Department, Autonomous University of Barcelona, Barcelona, Spain; Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Molina
authors.affiliation: Cardiology Department, Parc de Salut Mar, Barcelona, Spain; Medicine Department, Autonomous University of Barcelona, Barcelona, Spain; Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruguera
authors.affiliation: Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiology Department, Hospital Josep Trueta, Girona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Sala
authors.affiliation: Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiology Department, Hospital Josep Trueta, Girona, Spain.
authors.forename: Rafel
authors.initials: R
authors.lastname: Masià
authors.affiliation: Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular Risk and Nutrition Research Group (CARIN, REGICOR Study Group), IMIM, Spain; CIBER of Obesity Physiopathology and Nutrition (CIBEROBN), Spain.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Covas
authors.affiliation: Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular and Genetic Epidemiology Research Group (EGEC, REGICOR Study Group), IMIM, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.affiliation: Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular Risk and Nutrition Research Group (CARIN, REGICOR Study Group), IMIM, Spain; CIBER of Obesity Physiopathology and Nutrition (CIBEROBN), Spain. Electronic address: mfito@imim.es.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fitó
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D000906:Antibodies / Q000737:chemistry; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood; D010100:Oxygen / Q000737:chemistry; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain
chemical_list: D000906:Antibodies; D015415:Biomarkers; D008055:Lipids; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D010100:Oxygen
keywords: Ankle-brachial index; Atherosclerosis; Biomarkers; Cohort study; Intima-media thickness; Oxidation