Per-particle triglyceride-rich lipoproteins imply higher myocardial infarction risk than low-density lipoproteins copenhagen general population study

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OBJECTIVE: ApoB (Apolipoprotein B)-containing triglyceride-rich lipoproteins and LDL (low-density lipoproteins) are each causal for myocardial infarction and atherosclerotic cardiovascular disease; however, the relative importance is unknown. We tested the hypothesis that for the same number of nonfasting apoB-containing particles from smaller LDL through to larger triglyceride-rich lipoproteins, the risk of myocardial infarction is similar. APPROACH AND RESULTS: We included 29039 individuals with no history of myocardial infarction nested within 109751 individuals from the Copenhagen General Population Study. Particle number of apoB-containing lipoprotein subfractions were measured using nuclear magnetic resonance spectroscopy. During a mean follow-up of 10 years, 2309 individuals developed myocardial infarction. Multivariable-adjusted hazard ratios for myocardial infarction per 1×1015 particles were higher with larger size and more triglyceride content of apoB-containing lipoproteins using ten different subfractions, ranging from 11 (95% CI, 5.6-22) for extra extra large VLDL (very-low-density lipoproteins) to 1.06 (1.05-1.07) for extra small VLDL to 1.02 (1.01-1.02) for IDL (intermediate-density lipoproteins), through to 1.01 (1.01-1.01) for small LDL. When combining the particle number of 6 VLDL subfractions and combining IDL and 3 LDL subfractions, hazard ratios for myocardial infarction per 1×1017 particles were 3.5 (2.7-4.5) for VLDL and 1.3 (1.2-1.4) for IDL and LDL combined. CONCLUSIONS: For the same number of apoB-containing particles (1×1017 particles/L), the hazard ratio for myocardial infarction was 3.5-fold for VLDL and 1.3-fold for IDL and LDL combined. Biological implications include that VLDL particles are more atherogenic than LDL particles and clinically that VLDL and LDL should be measured separately.

OriginalsprogEngelsk
TidsskriftArteriosclerosis, Thrombosis, and Vascular Biology
Vol/bind41
Sider (fra-til)2063-2075
Antal sider13
ISSN1079-5642
DOI
StatusUdgivet - 2021

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© 2021 American Heart Association, Inc.

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