Lipids and Lipoproteins and Risk of Different Vascular Events in the MRC/BHF Heart Protection Study

Published on May 22, 2012in Circulation23.05
· DOI :10.1161/CIRCULATIONAHA.111.073684
S Parish55
Estimated H-index: 55
(Clinical Trial Service Unit),
Alison Offer9
Estimated H-index: 9
(Clinical Trial Service Unit)
+ 5 AuthorsRory Collins131
Estimated H-index: 131
(Clinical Trial Service Unit)
Background—Low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol are established risk factors for vascular disease, but lipoprotein particle concentrations may be stronger determinants of risk. Methods and Results—Associations between vascular events and baseline concentrations of cholesterol fractions, apolipoproteins B and A1, and lipoprotein particles assessed by nuclear magnetic resonance were considered in the Heart Protection Study randomized trial of simvastatin versus placebo (>5000 vascular events during 5.3 years of follow-up among 20 000 participants). Major occlusive coronary events were equally strongly associated with the cholesterol- and particle-based total LDL measures; adjusted hazard ratios per 1-SD-higher level were 1.25 (95% confidence interval [CI], 1.16–1.34) for LDL cholesterol, 1.22 (95% CI, 1.14–1.32) for non–HDL cholesterol, 1.23 (95% CI, 1.15–1.33) for apolipoprotein B, and 1.25 (95% CI, 1.16–1.35) for LDL particle number. Given the total LDL ...
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