Stroke mortality and the apoB/apoA‐I ratio: results of the AMORIS prospective study
. Objectives. LDL cholesterol is a well‐established risk factor for myocardial infarction, but not for stroke. The main objective of the present study was to determine if the risk of stroke is related to the balance between the proatherogenic apoB lipoprotein particles and the antiatherogenic apoA‐...
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| Veröffentlicht in: | Journal of internal medicine 2006-03, Vol.259 (3), p.259-266 |
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| description | .
Objectives. LDL cholesterol is a well‐established risk factor for myocardial infarction, but not for stroke. The main objective of the present study was to determine if the risk of stroke is related to the balance between the proatherogenic apoB lipoprotein particles and the antiatherogenic apoA‐I particles as is the case for myocardial infarction.
Subjects and design. A total of 98 722 men and 76 831 women were recruited from screening programmes. The prospective risk and the relationships between five different types of fatal strokes and the lipid fractions, apoB, apoA‐I and the apoB/apoA‐I ratio (automated immunoturbidimetry) were examined. The results were compared with the risks of other ischaemic and non‐ischaemic fatalities.
Results. Mean follow‐up was 10.3 years. High apoB and low apoA‐I values were significantly related to risk of stroke. The odds ratio comparing the upper 10th versus the 1st decile of the apoB/apoA‐I ratio for all strokes adjusted for age, gender, total cholesterol (TC) and triglycerides (TG) was 2.07 (95% CI: 1.49–2.88), P |
| doi_str_mv | 10.1111/j.1365-2796.2005.01610.x |
| format | Article |
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Objectives. LDL cholesterol is a well‐established risk factor for myocardial infarction, but not for stroke. The main objective of the present study was to determine if the risk of stroke is related to the balance between the proatherogenic apoB lipoprotein particles and the antiatherogenic apoA‐I particles as is the case for myocardial infarction.
Subjects and design. A total of 98 722 men and 76 831 women were recruited from screening programmes. The prospective risk and the relationships between five different types of fatal strokes and the lipid fractions, apoB, apoA‐I and the apoB/apoA‐I ratio (automated immunoturbidimetry) were examined. The results were compared with the risks of other ischaemic and non‐ischaemic fatalities.
Results. Mean follow‐up was 10.3 years. High apoB and low apoA‐I values were significantly related to risk of stroke. The odds ratio comparing the upper 10th versus the 1st decile of the apoB/apoA‐I ratio for all strokes adjusted for age, gender, total cholesterol (TC) and triglycerides (TG) was 2.07 (95% CI: 1.49–2.88), P < 0.0001. The strongest association was for ischaemic stroke. Low apoA‐I was a common abnormality in all stroke subtypes including subarachnoidal and haemorrhagic strokes. In multivariate analyses the apoB/apoA‐I ratio was a stronger risk predictor than total/HDL and LDL/HDL cholesterol ratios. The apoB/apoA‐I ratio was linearly related to the risk of stroke although the slope was less than observed for the risk of fatal myocardial infarction. For all ischaemic events pooled together the age‐, gender‐, TC‐ and TG‐adjusted odds ratio, 10th vs. 1st decile, was 3.13 (95% CI: 2.66–3.69), P < 0.0001. By contrast, there was no relationship between the apoB/apoA‐I ratio and risk of cancer or any other non‐ischaemic causes of death.
Conclusions. These observations link the apoB/apoA‐I ratio to the risk of fatal stroke in a similar fashion as for myocardial infarction and other ischaemic events. Our findings indicate that the apoB/apoA‐I ratio, which indicates the ‘cholesterol balance’, is a robust and specific maker of virtually all ischaemic events.</description><identifier>ISSN: 0954-6820</identifier><identifier>EISSN: 1365-2796</identifier><identifier>DOI: 10.1111/j.1365-2796.2005.01610.x</identifier><identifier>PMID: 16476103</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Apolipoprotein A-I - blood ; apolipoprotein A‐I ; apolipoprotein B ; Apolipoproteins B - blood ; Biological and medical sciences ; Biomarkers - blood ; Cerebral Infarction - blood ; Cerebral Infarction - mortality ; Epidemiologic Methods ; fatal events ; Female ; General aspects ; Humans ; Male ; Medical sciences ; Middle Aged ; myocardial infarction ; Myocardial Infarction - blood ; Myocardial Infarction - mortality ; Neurology ; prospective study ; stroke ; Stroke - blood ; Stroke - mortality ; Sweden - epidemiology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Journal of internal medicine, 2006-03, Vol.259 (3), p.259-266</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Blackwell Publishing Mar 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5790-5921b4ececd929b7a0fb5557c84b3349979a9c9d6b7128f0dc844572a10b688e3</citedby><cites>FETCH-LOGICAL-c5790-5921b4ececd929b7a0fb5557c84b3349979a9c9d6b7128f0dc844572a10b688e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2796.2005.01610.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2796.2005.01610.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17503560$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16476103$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:1934310$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>WALLDIUS, G.</creatorcontrib><creatorcontrib>AASTVEIT, A. H.</creatorcontrib><creatorcontrib>JUNGNER, I.</creatorcontrib><title>Stroke mortality and the apoB/apoA‐I ratio: results of the AMORIS prospective study</title><title>Journal of internal medicine</title><addtitle>J Intern Med</addtitle><description>.
Objectives. LDL cholesterol is a well‐established risk factor for myocardial infarction, but not for stroke. The main objective of the present study was to determine if the risk of stroke is related to the balance between the proatherogenic apoB lipoprotein particles and the antiatherogenic apoA‐I particles as is the case for myocardial infarction.
Subjects and design. A total of 98 722 men and 76 831 women were recruited from screening programmes. The prospective risk and the relationships between five different types of fatal strokes and the lipid fractions, apoB, apoA‐I and the apoB/apoA‐I ratio (automated immunoturbidimetry) were examined. The results were compared with the risks of other ischaemic and non‐ischaemic fatalities.
Results. Mean follow‐up was 10.3 years. High apoB and low apoA‐I values were significantly related to risk of stroke. The odds ratio comparing the upper 10th versus the 1st decile of the apoB/apoA‐I ratio for all strokes adjusted for age, gender, total cholesterol (TC) and triglycerides (TG) was 2.07 (95% CI: 1.49–2.88), P < 0.0001. The strongest association was for ischaemic stroke. Low apoA‐I was a common abnormality in all stroke subtypes including subarachnoidal and haemorrhagic strokes. In multivariate analyses the apoB/apoA‐I ratio was a stronger risk predictor than total/HDL and LDL/HDL cholesterol ratios. The apoB/apoA‐I ratio was linearly related to the risk of stroke although the slope was less than observed for the risk of fatal myocardial infarction. For all ischaemic events pooled together the age‐, gender‐, TC‐ and TG‐adjusted odds ratio, 10th vs. 1st decile, was 3.13 (95% CI: 2.66–3.69), P < 0.0001. By contrast, there was no relationship between the apoB/apoA‐I ratio and risk of cancer or any other non‐ischaemic causes of death.
Conclusions. These observations link the apoB/apoA‐I ratio to the risk of fatal stroke in a similar fashion as for myocardial infarction and other ischaemic events. Our findings indicate that the apoB/apoA‐I ratio, which indicates the ‘cholesterol balance’, is a robust and specific maker of virtually all ischaemic events.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Apolipoprotein A-I - blood</subject><subject>apolipoprotein A‐I</subject><subject>apolipoprotein B</subject><subject>Apolipoproteins B - blood</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cerebral Infarction - blood</subject><subject>Cerebral Infarction - mortality</subject><subject>Epidemiologic Methods</subject><subject>fatal events</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>myocardial infarction</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - mortality</subject><subject>Neurology</subject><subject>prospective study</subject><subject>stroke</subject><subject>Stroke - blood</subject><subject>Stroke - mortality</subject><subject>Sweden - epidemiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0954-6820</issn><issn>1365-2796</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkctO3DAUhq2qqAzQV6isSmWXwY7jGwukKYIyFWgkLmvLcRw1Q2ac2g4wOx6hz9gnqcNEIHWFF_aRz_efi34AIEZTnM7RcooJo1nOJZvmCNEpwizlnj6AyWviI5ggSYuMiRztgr0Qlghhghj6BHYxK3gSkAm4u4ne3Vu4cj7qtokbqNcVjL8s1J37fpSu2d_nP3PodWzcMfQ29G0M0NUvzOxqcT2_gZ13obMmNg8WhthXmwOwU-s22M_juw_uzs9uTy-yy8WP-ensMjOUS5RRmeOysMaaSuay5BrVJaWUG1GUhBRScqmlkRUrOc5FjaqUKCjPNUYlE8KSfZBt64ZH2_Wl6nyz0n6jnG7U-HWfIqsoZ0LKxB9u-TTx796GqFZNMLZt9dq6PijGGZWE8wR-_Q9cut6v0y4Kp6lYToRIkNhCJu0fvK1f-2OkBp_UUg12qMEONfikXnxST0n6ZazflytbvQlHYxLwbQR0MLqtvV6bJrxxnCJCGUrcyZZ7bFq7efcA6udifjWE5B_UWa35</recordid><startdate>200603</startdate><enddate>200603</enddate><creator>WALLDIUS, G.</creator><creator>AASTVEIT, A. H.</creator><creator>JUNGNER, I.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>200603</creationdate><title>Stroke mortality and the apoB/apoA‐I ratio: results of the AMORIS prospective study</title><author>WALLDIUS, G. ; AASTVEIT, A. H. ; JUNGNER, I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5790-5921b4ececd929b7a0fb5557c84b3349979a9c9d6b7128f0dc844572a10b688e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Apolipoprotein A-I - blood</topic><topic>apolipoprotein A‐I</topic><topic>apolipoprotein B</topic><topic>Apolipoproteins B - blood</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cerebral Infarction - blood</topic><topic>Cerebral Infarction - mortality</topic><topic>Epidemiologic Methods</topic><topic>fatal events</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>myocardial infarction</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - mortality</topic><topic>Neurology</topic><topic>prospective study</topic><topic>stroke</topic><topic>Stroke - blood</topic><topic>Stroke - mortality</topic><topic>Sweden - epidemiology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WALLDIUS, G.</creatorcontrib><creatorcontrib>AASTVEIT, A. H.</creatorcontrib><creatorcontrib>JUNGNER, I.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Journal of internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WALLDIUS, G.</au><au>AASTVEIT, A. H.</au><au>JUNGNER, I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stroke mortality and the apoB/apoA‐I ratio: results of the AMORIS prospective study</atitle><jtitle>Journal of internal medicine</jtitle><addtitle>J Intern Med</addtitle><date>2006-03</date><risdate>2006</risdate><volume>259</volume><issue>3</issue><spage>259</spage><epage>266</epage><pages>259-266</pages><issn>0954-6820</issn><eissn>1365-2796</eissn><abstract>.
Objectives. LDL cholesterol is a well‐established risk factor for myocardial infarction, but not for stroke. The main objective of the present study was to determine if the risk of stroke is related to the balance between the proatherogenic apoB lipoprotein particles and the antiatherogenic apoA‐I particles as is the case for myocardial infarction.
Subjects and design. A total of 98 722 men and 76 831 women were recruited from screening programmes. The prospective risk and the relationships between five different types of fatal strokes and the lipid fractions, apoB, apoA‐I and the apoB/apoA‐I ratio (automated immunoturbidimetry) were examined. The results were compared with the risks of other ischaemic and non‐ischaemic fatalities.
Results. Mean follow‐up was 10.3 years. High apoB and low apoA‐I values were significantly related to risk of stroke. The odds ratio comparing the upper 10th versus the 1st decile of the apoB/apoA‐I ratio for all strokes adjusted for age, gender, total cholesterol (TC) and triglycerides (TG) was 2.07 (95% CI: 1.49–2.88), P < 0.0001. The strongest association was for ischaemic stroke. Low apoA‐I was a common abnormality in all stroke subtypes including subarachnoidal and haemorrhagic strokes. In multivariate analyses the apoB/apoA‐I ratio was a stronger risk predictor than total/HDL and LDL/HDL cholesterol ratios. The apoB/apoA‐I ratio was linearly related to the risk of stroke although the slope was less than observed for the risk of fatal myocardial infarction. For all ischaemic events pooled together the age‐, gender‐, TC‐ and TG‐adjusted odds ratio, 10th vs. 1st decile, was 3.13 (95% CI: 2.66–3.69), P < 0.0001. By contrast, there was no relationship between the apoB/apoA‐I ratio and risk of cancer or any other non‐ischaemic causes of death.
Conclusions. These observations link the apoB/apoA‐I ratio to the risk of fatal stroke in a similar fashion as for myocardial infarction and other ischaemic events. Our findings indicate that the apoB/apoA‐I ratio, which indicates the ‘cholesterol balance’, is a robust and specific maker of virtually all ischaemic events.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>16476103</pmid><doi>10.1111/j.1365-2796.2005.01610.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Apolipoprotein A-I - blood apolipoprotein A‐I apolipoprotein B Apolipoproteins B - blood Biological and medical sciences Biomarkers - blood Cerebral Infarction - blood Cerebral Infarction - mortality Epidemiologic Methods fatal events Female General aspects Humans Male Medical sciences Middle Aged myocardial infarction Myocardial Infarction - blood Myocardial Infarction - mortality Neurology prospective study stroke Stroke - blood Stroke - mortality Sweden - epidemiology Vascular diseases and vascular malformations of the nervous system |
| title | Stroke mortality and the apoB/apoA‐I ratio: results of the AMORIS prospective study |
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