Prognostic value of apolipoprotein B and A-I in the prediction of myocardial infarction in middle-aged men and women: results from the MONICA/KORA Augsburg cohort study

Eur Heart J. 2005 Feb;26(3):271-8. doi: 10.1093/eurheartj/ehi003. Epub 2004 Nov 30.

Abstract

Aims: To investigate the association between apolipoprotein B (apoB), A-I (apoA-I), the apoB/apoA-I ratio, and the incidence of coronary events.

Methods and results: Analysis included 1414 men and 1436 women aged 35-64 years without a prior coronary event who participated in the population-based MONICA Augsburg survey 1984-85 (median followed-up period 13 years). Incidence of fatal and non-fatal myocardial infarction, and sudden cardiac death was assessed using data of the MONICA/KORA Augsburg coronary event registry. During follow-up, 114 incident coronary events occurred in men and 31 in women. In multivariable analysis, an increase of 1 standard deviation in the serum concentration of apoB was associated with an increased risk of coronary events in men [hazard ratio (HR)=1.49; 95% confidence interval (CI); 1.25-1.78] and in women (HR=1.73; 95% CI; 1.32-2.27). By contrast, elevated concentrations of apoA-I were not associated with a significantly decreased risk of coronary events in either sex (HR=0.91). Furthermore, the predictive power of the apoB/apoA-I ratio was similar to that of the total cholesterol/HDL cholesterol ratio in men and women.

Conclusion: ApoB and the apoB/apoA-I ratio were strong predictors of coronary events in middle-aged men and women, whereas apoA-I did not add significantly to the estimation of future coronary risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Apolipoprotein A-I / blood*
  • Apolipoproteins B / blood*
  • Area Under Curve
  • Biomarkers / blood
  • Cholesterol, HDL / blood
  • Cohort Studies
  • Death, Sudden, Cardiac / etiology
  • Female
  • Germany / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / blood
  • Myocardial Infarction / mortality*
  • Prognosis

Substances

  • Apolipoprotein A-I
  • Apolipoproteins B
  • Biomarkers
  • Cholesterol, HDL