Complementary prediction of cardiovascular events by estimated apo-and lipoprotein concentrations in the working age population. The Health 2000 Study

Niku Oksala, Ilkka Seppälä, Jussi Hernesniemi, Leo Pekka Lyytikäinen, Mika Kähönen, Kari Matti Mäkelä, Antti Reunanen, Antti Jula, Mika Ala-Korpela, Terho Lehtimäki

Research output: Contribution to journalArticleScientificpeer-review

5 Citations (Scopus)

Abstract

Background. Apolipoprotein A-I (apoA-I) and B (apoB) and multiple lipoprotein cardiovascular risk factors can be computationally estimated with our extended Friedewald approach (EFW) from class classical inputs. Their impact on cardiovascular events and mortality in the working age population is not known. Methods. The working age ( ≥ 65 years, n = 5956) prospective populationbased cohort (follow-up of 7.8 ± 0.9 years: 46,572 patient years, 409 non-fatal incident cardiovascular events, and 55 cardiovascular and 266 all-cause deaths) had their total serum cholesterol (TC), triglycerides (TG), and HDL-C measured. Continuous net reclassifi cation improvement (NRI) was calculated. Results. In Cox models adjusted with cardiovascular risk factors, EFW-HDL2-C (HR 0.78, 95% CI 0.67-0.91: NRI 16.5%), apoA-I (HR 0.78, 95% CI 0.69-0.89: NRI 15.2%), apoB/apoA-I (HR 1.23, 95% CI 1.08-1.40: NRI 20.6%), and VLDL-TG (HR 1.15, 95% CI 1.05-1.25: NRI 20.1%) were associated with incident non-fatal cardiovascular events and improved risk prediction compared with TC, LDL-C, or non-HDL-C. Cardiovascular deaths could be best predicted with EFW apoB (HR 1.81, 95% CI 1.18-2.77: NRI 77.3%). Conclusions. EFW approach-derived HDL 2-C, apoA-I, apoB/apoA-I, and VLDL-TG improve prediction of non-fatal cardiovascular events, and apoB of cardiovascular mortality, and can be utilized for risk estimation in a working age population without extra cost.

Original languageEnglish
Pages (from-to)141-148
Number of pages8
JournalANNALS OF MEDICINE
Volume45
Issue number2
DOIs
Publication statusPublished - 2013
Publication typeA1 Journal article-refereed

Keywords

  • Apolipoproteins
  • Friedewald
  • cardiovascular
  • computational methods
  • events
  • extended
  • mortality
  • neural networks

Publication forum classification

  • Publication forum level 2

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