TY - JOUR
T1 - Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study)
T2 - a case-control study
AU - McQueen, Matthew J.
AU - Hawken, Steven
AU - Wang, Xingyu
AU - Ounpuu, Stephanie
AU - Sniderman, Allan
AU - Probstfield, Jeffrey
AU - Steyn, Krisela
AU - Sanderson, John E.
AU - Hasani, Mohammad
AU - Volkova, Emilia
AU - Kazmi, Khawar
AU - Yusuf, Salim
N1 - Funding Information:
The INTERHEART study was funded by the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Ontario, the International Clinical Epidemiology Network (INCLEN), and through unrestricted grants from several pharmaceutical companies (with major contributions from AstraZeneca, Novartis, Hoechst Marion Roussel [now Aventis], Knoll Pharmaceuticals [now Abbott], Bristol Myers Squibb, and Sanofi-Synthelabo), and by various national bodies in different countries: Chile—Universidad de la Frontera, Sociedad Chilena de Cardiologia Filial Sur; Colombia—Colciencias, Ministerio de Salud; Croatia—Croatian Ministry of Science and Technology; Guatemala—Liga Guatemalteca del Corazon; Hungary—Astra Hassle, National Health Science Council, George Gabor Foundation; Iran—Iran Ministry of Health; Italy—Boehringer-Ingelheim; Japan—Sankyo Pharmaceutical, Banyu Pharmaceutical, Astra Japan; Kuwait—Endowment Fund for Health Development in Kuwait; Pakistan—ATCO Laboratories; Philippines—Philippine Council for Health Research and Development, INCLEN, Pfizer Philippines Foundation, Astra Pharmaceuticals, Astra Fund for Clinical Research and Continuing Medical Education, Pharmacia and Upjohn; Poland—Foundation PROCLINICA, State Committee for Scientific Research; Singapore—Singapore National Heart Association; South Africa—MRC South Africa, Warner-Parke-Davis Pharmaceuticals, Aventis; Sweden—Grant from the Swedish State under LUA Agreement, Swedish Heart and Lung Foundation; Thailand—The Heart Association of Thailand, Thailand Research Fund; USA—King Pharma.
PY - 2008
Y1 - 2008
N2 - Background: Whether lipoproteins are better markers than lipids and lipoproteins for coronary heart disease is widely debated. Our aim was to compare the apolipoproteins and cholesterol as indices for risk of acute myocardial infarction. Methods: We did a large, standardised case-control study of acute myocardial infarction in 12 461 cases and 14 637 age-matched (plus or minus 5 years) and sex-matched controls in 52 countries. Non-fasting blood samples were available from 9345 cases and 12 120 controls. Concentrations of plasma lipids, lipoproteins, and apolipoproteins were measured, and cholesterol and apolipoprotein ratios were calculated. Odds ratios (OR) and 95% CI, and population-attributable risks (PARs) were calculated for each measure overall and for each ethnic group by comparison of the top four quintiles with the lowest quintile. Findings: The apolipoprotein B100 (ApoB)/apolipoprotein A1 (ApoA1) ratio had the highest PAR (54%) and the highest OR with each 1 SD difference (1·59, 95% CI 1·53-1·64). The PAR for ratio of LDL cholesterol/HDL cholesterol was 37%. PAR for total cholesterol/HDL cholesterol was 32%, which was substantially lower than that of the ApoB/ApoA1 ratio (p<0·0001). These results were consistent in all ethnic groups, men and women, and for all ages. Interpretation: The non-fasting ApoB/ApoA1 ratio was superior to any of the cholesterol ratios for estimation of the risk of acute myocardial infarction in all ethnic groups, in both sexes, and at all ages, and it should be introduced into worldwide clinical practice. Funding: Canadian Institutes of Health Research, the Heart and Stroke Foundation of Ontario, the International Clinical Epidemiology Network (INCLEN). Unrestricted grants from pharmaceutical companies (with major contributions from AstraZeneca, Novartis, Aventis, Abbott, Bristol Myers Squibb, King Pharma, and Sanofi-Synthelabo), and by various national bodies.
AB - Background: Whether lipoproteins are better markers than lipids and lipoproteins for coronary heart disease is widely debated. Our aim was to compare the apolipoproteins and cholesterol as indices for risk of acute myocardial infarction. Methods: We did a large, standardised case-control study of acute myocardial infarction in 12 461 cases and 14 637 age-matched (plus or minus 5 years) and sex-matched controls in 52 countries. Non-fasting blood samples were available from 9345 cases and 12 120 controls. Concentrations of plasma lipids, lipoproteins, and apolipoproteins were measured, and cholesterol and apolipoprotein ratios were calculated. Odds ratios (OR) and 95% CI, and population-attributable risks (PARs) were calculated for each measure overall and for each ethnic group by comparison of the top four quintiles with the lowest quintile. Findings: The apolipoprotein B100 (ApoB)/apolipoprotein A1 (ApoA1) ratio had the highest PAR (54%) and the highest OR with each 1 SD difference (1·59, 95% CI 1·53-1·64). The PAR for ratio of LDL cholesterol/HDL cholesterol was 37%. PAR for total cholesterol/HDL cholesterol was 32%, which was substantially lower than that of the ApoB/ApoA1 ratio (p<0·0001). These results were consistent in all ethnic groups, men and women, and for all ages. Interpretation: The non-fasting ApoB/ApoA1 ratio was superior to any of the cholesterol ratios for estimation of the risk of acute myocardial infarction in all ethnic groups, in both sexes, and at all ages, and it should be introduced into worldwide clinical practice. Funding: Canadian Institutes of Health Research, the Heart and Stroke Foundation of Ontario, the International Clinical Epidemiology Network (INCLEN). Unrestricted grants from pharmaceutical companies (with major contributions from AstraZeneca, Novartis, Aventis, Abbott, Bristol Myers Squibb, King Pharma, and Sanofi-Synthelabo), and by various national bodies.
UR - http://www.scopus.com/inward/record.url?scp=47149103896&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(08)61076-4
DO - 10.1016/S0140-6736(08)61076-4
M3 - Article
C2 - 18640459
AN - SCOPUS:47149103896
SN - 0140-6736
VL - 372
SP - 224
EP - 233
JO - The Lancet
JF - The Lancet
IS - 9634
ER -