Low-Density Lipoproteins Containing Apolipoprotein C-III and the Risk of Coronary Heart Disease
Mendivil, C. O.
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CitationMendivil, C. O., E. B. Rimm, J. Furtado, S. E. Chiuve, and F. M. Sacks. 2011. “Low-Density Lipoproteins Containing Apolipoprotein C-III and the Risk of Coronary Heart Disease.” Circulation 124 (19) (October 10): 2065–2072. doi:10.1161/circulationaha.111.056986.
Low-density lipoprotein (LDL) that contains apolipoprotein (apo) C-III makes up only 10% to 20% of plasma LDL but has a markedly altered metabolism and proatherogenic effects on vascular cells.
METHODS AND RESULTS:
We examined the association between plasma LDL with apoC-III and coronary heart disease in 320 women and 419 men initially free of cardiovascular disease who developed a fatal or nonfatal myocardial infarction during 10 to 14 years of follow-up and matched controls who remained free of coronary heart disease. Concentrations of LDL with apoC-III (measured as apoB in this fraction) were associated with risk of coronary heart disease in multivariable analysis that included the ratio of total cholesterol to high-density lipoprotein cholesterol, LDL cholesterol, apoB, triglycerides, or high-density lipoprotein cholesterol and other risk factors. In all models, the relative risks for the top versus bottom quintile of LDL with apoC-III were greater than those for LDL without apoC-III. When included in the same multivariable-adjusted model, the risk associated with LDL with apoC-III (relative risk for top versus bottom quintile, 2.38; 95% confidence interval, 1.54-3.68; P for trend <0.001) was significantly greater than that associated with LDL without apoC-III (relative risk for top versus bottom quintile, 1.25; 95% confidence interval, 0.76-2.05; P for trend=0.97; P for interaction <0.001). This divergence in association with coronary heart disease persisted even after adjustment for plasma triglycerides.
The risk of coronary heart disease contributed by LDL appeared to result to a large extent from LDL that contains apoC-III.
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