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Interplay of Atherogenic Particle Number and Particle Size and the Risk of Coronary Heart Disease.

Publication ,  Journal Article
Pencina, KM; Pencina, MJ; Lawler, PR; Engert, JC; Dufresne, L; Ridker, PM; Thanassoulis, G; Mora, S; Sniderman, AD
Published in: Clin Chem
January 4, 2023

BACKGROUND: We examined the interplay of apolipoprotein B (apoB) and LDL particle size, approximated by the LDL-cholesterol (LDL-C)/apoB ratio, on the risk of new-onset coronary heart disease (CHD). METHODS: Participants without cardiovascular disease from the UK Biobank (UKB; n = 308 182), the Women's Health Study (WHS; n = 26 204), and the Framingham Heart Study (FHS; n = 2839) were included. Multivariable Cox models were used to assess the relationship between apoB and LDL-C/apoB ratio and incidence of CHD (14 994 events). Our analyses were adjusted for age, sex (except WHS), HDL-cholesterol (HDL-C), systolic blood pressure, antihypertensive treatment, diabetes, and smoking. RESULTS: In all 3 studies, there was a strong positive correlation between apoB and LDL-C (correlation coefficients r = 0.80 or higher) and a weak inverse correlation of apoB with LDL-C/apoB ratio (-0.28 ≤ r ≤ -0.14). For all 3 cohorts, CHD risk was higher for higher levels of apoB. Upon multivariable adjustment, the association between apoB and new-onset CHD remained robust and statistically significant in all 3 cohorts with hazard ratios per 1 SD (95% CI): 1.24 (1.22-1.27), 1.33 (1.20-1.47), and 1.24 (1.09-1.42) for UKB, WHS, and FHS, respectively. However, the association between LDL-C/apoB and CHD was statistically significant only in the FHS cohort: 0.78 (0.64-0.94). CONCLUSIONS: Our analysis confirms that apoB is a strong risk factor for CHD. However, given the null association in 2 of the 3 studies, we cannot confirm that cholesterol-depleted LDL particles are substantially more atherogenic than cholesterol-replete particles. These results lend further support to routine measurement of apoB in clinical care.

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Published In

Clin Chem

DOI

EISSN

1530-8561

Publication Date

January 4, 2023

Volume

69

Issue

1

Start / End Page

48 / 55

Location

England

Related Subject Headings

  • Risk Factors
  • Particle Size
  • Humans
  • General Clinical Medicine
  • Female
  • Coronary Disease
  • Cholesterol, LDL
  • Cholesterol, HDL
  • Cholesterol
  • Apolipoproteins B
 

Citation

APA
Chicago
ICMJE
MLA
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Pencina, K. M., Pencina, M. J., Lawler, P. R., Engert, J. C., Dufresne, L., Ridker, P. M., … Sniderman, A. D. (2023). Interplay of Atherogenic Particle Number and Particle Size and the Risk of Coronary Heart Disease. Clin Chem, 69(1), 48–55. https://doi.org/10.1093/clinchem/hvac172
Pencina, Karol M., Michael J. Pencina, Patrick R. Lawler, James C. Engert, Line Dufresne, Paul M. Ridker, George Thanassoulis, Samia Mora, and Allan D. Sniderman. “Interplay of Atherogenic Particle Number and Particle Size and the Risk of Coronary Heart Disease.Clin Chem 69, no. 1 (January 4, 2023): 48–55. https://doi.org/10.1093/clinchem/hvac172.
Pencina KM, Pencina MJ, Lawler PR, Engert JC, Dufresne L, Ridker PM, et al. Interplay of Atherogenic Particle Number and Particle Size and the Risk of Coronary Heart Disease. Clin Chem. 2023 Jan 4;69(1):48–55.
Pencina, Karol M., et al. “Interplay of Atherogenic Particle Number and Particle Size and the Risk of Coronary Heart Disease.Clin Chem, vol. 69, no. 1, Jan. 2023, pp. 48–55. Pubmed, doi:10.1093/clinchem/hvac172.
Pencina KM, Pencina MJ, Lawler PR, Engert JC, Dufresne L, Ridker PM, Thanassoulis G, Mora S, Sniderman AD. Interplay of Atherogenic Particle Number and Particle Size and the Risk of Coronary Heart Disease. Clin Chem. 2023 Jan 4;69(1):48–55.

Published In

Clin Chem

DOI

EISSN

1530-8561

Publication Date

January 4, 2023

Volume

69

Issue

1

Start / End Page

48 / 55

Location

England

Related Subject Headings

  • Risk Factors
  • Particle Size
  • Humans
  • General Clinical Medicine
  • Female
  • Coronary Disease
  • Cholesterol, LDL
  • Cholesterol, HDL
  • Cholesterol
  • Apolipoproteins B