European Heart Journal Advance Access originally published online on November 30, 2004
European Heart Journal 2005 26(3):271-278; doi:10.1093/eurheartj/ehi003
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European Heart Journal vol. 26 no. 3 © The European Society of Cardiology 2004; all rights reserved.
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
1Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany
2GSF, Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
3Klinikum der Universität München, Institute of Clinical Chemistry, Munich, Germany
4Department of Internal Medicine II—Cardiology, University of Ulm Medical Center, Ulm, Germany
Received 10 February 2004; revised 27 September 2004; accepted 14 October 2004; online publish-ahead-of-print 30 November 2004.
* Corresponding author: Department of Internal Medicine II—Cardiology, University of Ulm Medical Center, Robert-Koch Str. 8, D-89081 Ulm, Germany. Tel: +49 731 500 24441; fax: +49 731 500 33872. E-mail address: wolfgang.koenig{at}medizin.uni-ulm.de
See page 210 for the editorial comment on this article (doi:10.1093/eurheartj/ehi077)
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.
Key Words: Cohort study • Apolipoprotein B • Apolipoprotein A-I • Coronary event • Prognostic value
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