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Association of circulating cholesteryl ester transfer protein activity with incidence of cardiovascular disease in the community.

Publication ,  Journal Article
Vasan, RS; Pencina, MJ; Robins, SJ; Zachariah, JP; Kaur, G; D'Agostino, RB; Ordovas, JM
Published in: Circulation
December 15, 2009

BACKGROUND: Plasma high-density lipoprotein cholesterol concentration is related inversely to the risk of cardiovascular disease (CVD). Inhibiting cholesteryl ester transfer protein (CETP) activity raises high-density lipoprotein cholesterol and may be cardioprotective, but an initial clinical trial with a CETP inhibitor was stopped prematurely because of increased CVD in treated patients, raising concerns about this approach. Data relating circulating CETP concentrations to CVD incidence in the community are conflicting. METHODS AND RESULTS: Plasma CETP activity was measured in 1978 Framingham Heart Study participants (mean age, 51 years; 54% women) who attended a routine examination in 1987-1990 and were free of CVD. On follow-up (mean, 15.1 years), 320 participants experienced a first CVD event (fatal or nonfatal coronary heart disease, cerebrovascular disease, peripheral vascular disease, or heart failure). In multivariable analyses adjusted for standard risk factors including high-density lipoprotein cholesterol, plasma CETP activity was related inversely to the incidence of CVD events (hazard ratio for activity, at or above the median of 0.72; 95% confidence interval, 0.57 to 0.90; P=0.004 [compared with below median]; hazard ratio per SD increment, 0.86; 95% confidence interval, 0.76 to 0.97; P=0.01). The inverse association of CETP activity with CVD incidence remained robust in time-dependent models updating standard risk factors every 4 years and was maintained in analyses of incident "hard" CVD events (myocardial infarction, stroke, or heart failure). CONCLUSIONS: In our prospective investigation of a community-based sample, lower plasma CETP activity was associated with greater CVD risk. These observations, if confirmed, challenge the concept that CETP inhibition may lower CVD risk.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 15, 2009

Volume

120

Issue

24

Start / End Page

2414 / 2420

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Residence Characteristics
  • Prospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Vasan, R. S., Pencina, M. J., Robins, S. J., Zachariah, J. P., Kaur, G., D’Agostino, R. B., & Ordovas, J. M. (2009). Association of circulating cholesteryl ester transfer protein activity with incidence of cardiovascular disease in the community. Circulation, 120(24), 2414–2420. https://doi.org/10.1161/CIRCULATIONAHA.109.872705
Vasan, Ramachandran S., Michael J. Pencina, Sander J. Robins, Justin P. Zachariah, Guneet Kaur, Ralph B. D’Agostino, and Jose M. Ordovas. “Association of circulating cholesteryl ester transfer protein activity with incidence of cardiovascular disease in the community.Circulation 120, no. 24 (December 15, 2009): 2414–20. https://doi.org/10.1161/CIRCULATIONAHA.109.872705.
Vasan RS, Pencina MJ, Robins SJ, Zachariah JP, Kaur G, D’Agostino RB, et al. Association of circulating cholesteryl ester transfer protein activity with incidence of cardiovascular disease in the community. Circulation. 2009 Dec 15;120(24):2414–20.
Vasan, Ramachandran S., et al. “Association of circulating cholesteryl ester transfer protein activity with incidence of cardiovascular disease in the community.Circulation, vol. 120, no. 24, Dec. 2009, pp. 2414–20. Pubmed, doi:10.1161/CIRCULATIONAHA.109.872705.
Vasan RS, Pencina MJ, Robins SJ, Zachariah JP, Kaur G, D’Agostino RB, Ordovas JM. Association of circulating cholesteryl ester transfer protein activity with incidence of cardiovascular disease in the community. Circulation. 2009 Dec 15;120(24):2414–2420.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 15, 2009

Volume

120

Issue

24

Start / End Page

2414 / 2420

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Residence Characteristics
  • Prospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Follow-Up Studies
  • Female