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.
Originalsprog | Engelsk |
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Tidsskrift | Arteriosclerosis, Thrombosis, and Vascular Biology |
Vol/bind | 41 |
Sider (fra-til) | 2063-2075 |
Antal sider | 13 |
ISSN | 1079-5642 |
DOI | |
Status | Udgivet - 2021 |
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Publisher Copyright:
© 2021 American Heart Association, Inc.
ID: 272237225