Relation Between Baseline and On-Treatment Lipid Parameters and First Acute Major Coronary Events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)

Gotto, Antonio M.; Whitney, Edwin J.; Stein, Evan A.; Shapiro, Deborah R.; Clearfield, Michael; Weis, Stephen E.; Jou, Jesse Y.; Langendörfer, Alexandra; Beere, Polly A.; Watson, Douglas J.; Downs, John R.; Cani, John S. de

doi:10.1161/01.cir.101.5.477

Cited by 500 publications

(298 citation statements)

References 22 publications

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“…This finding is consistent with those of other large statin trials in which the relative risk reduction was similar in subjects with high, average, and low LDL cholesterol levels. [27][28][29] In the present study, there was no association between WBC and LDL cholesterol, which is consistent with studies that found no association between C-reactive protein and LDL cholesterol. 4 -6 These observations are consistent with the hypothesis that WBC and LDL cholesterol level influence cardiac risk by different pathways.…”

Section: Stewart Et Al White Blood Count Pravastatin Coronary Mortasupporting

confidence: 92%

White Blood Cell Count Predicts Reduction in Coronary Heart Disease Mortality With Pravastatin

et al. 2005

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Background-Elevated serum inflammatory marker levels are associated with a greater long-term risk of cardiovascular events. Because 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors (statins) may have an antiinflammatory action, it has been suggested that patients with elevated inflammatory marker levels may have a greater reduction in cardiovascular risk with statin treatment. Methods and Results-We evaluated the association between the white blood cell count (WBC) and coronary heart disease mortality during a mean follow-up of 6.0 years in the Long-Term Intervention With Pravastatin in Ischemic Disease (LIPID) Study, a clinical trial comparing pravastatin (40 mg/d) with a placebo in 9014 stable patients with previous myocardial infarction or unstable angina. An increase in baseline WBC was associated with greater coronary heart disease mortality in patients randomized to placebo (hazard ratio for 1ϫ10 9 /L increase in WBC, 1.18; 95% CI, 1.12 to 1.25; PϽ0.001) but not pravastatin (hazard ratio, 1.02; 95% CI, 0.96 to 1.09; Pϭ0.56; P for interactionϭ0.004). The numbers of coronary heart disease deaths prevented per 1000 patients treated with pravastatin were 0, 9, 30, and 38 for baseline WBC quartiles of Ͻ5.9, 6.0 to 6.9, 7.0 to 8.1, and Ͼ8.2ϫ10 9 /L, respectively. WBC was a stronger predictor of this treatment benefit than the ratio of total to high-density lipoprotein cholesterol and a global measure of cardiac risk. There was also a greater reduction (Pϭ0.052) in the combined incidence of cardiovascular mortality, nonfatal myocardial infarction, and stroke with pravastatin as baseline WBC increased (by quartile: 3, 41, 61, and 60 events prevented per 1000 patients treated, respectively). Conclusions-These

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Section: Stewart Et Al White Blood Count Pravastatin Coronary Mortasupporting

confidence: 92%

White Blood Cell Count Predicts Reduction in Coronary Heart Disease Mortality With Pravastatin

et al. 2005

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“…14,15 However, in a reproducibility study among 82 men from the Health Professionals Follow-Up Study, the intraclass correlation coefficients for plasma lipids collected 3 to 4 years apart were Ͼ0.7 for all lipids. Second, because we did not have full measurements of apoA-I, we could not assess the suggested 16,17 predictive value of apoB 100 /apoA-I. However, apoA-I did not add additional value over HDL-C in predicting CHD.…”

Section: Discussionmentioning

confidence: 97%

Multivariate Assessment of Lipid Parameters as Predictors of Coronary Heart Disease Among Postmenopausal Women

et al. 2004

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Background— Over the past decade, lipid measurements have been significantly improved and standardized. We evaluated the usefulness of multiple plasma lipid parameters in predicting coronary heart diseases (CHD) among women. Methods and Results— Among 32 826 women from the Nurses’ Health Study who provided blood samples at baseline, 234 CHD events were documented during 8 years of follow-up. In a nested study, these cases were matched to controls (1:2) for age, smoking, fasting status, and month of blood draw. We estimated the relative risk (RR) for each lipid parameter, adjusted for C-reactive protein, homocysteine, body mass index, family history, hypertension, diabetes, postmenopausal hormone use, physical activity, alcohol intake, and blood draw parameters. The RRs associated with an increase of ≈1 SD (mg/dL) were as follows: HDL cholesterol (HDL-C) (RR=0.6 [0.5 to 0.8], SD=17), apolipoprotein B 100 (apoB 100 ) (RR=1.7 [1.4 to 2.1], SD=32), LDL cholesterol (LDL-C) (RR=1.4 [1.1 to 1.7], SD=36), total cholesterol (TC) (RR=1.4 [1.1 to 1.6], SD=40), and triglycerides (RR=1.3 [1.0 to 1.5], SD=80). Among the lipid indexes, the RRs were: apoB 100 /HDL-C (RR=1.7 [1.4 to 2.1], SD=1.0), TC/HDL-C (RR=1.6 [1.3 to 1.9], SD=1.3), LDL-C/HDL-C (RR=1.5 [1.3 to 1.9], SD=1.0), and non–HDL-C (RR=1.6 [1.3 to 1.9], SD=42 mg/dL). After simultaneous control for several lipid biomarkers, HDL-C was the primary contributor of the variation in multivariate models ( P =0.01), followed by LDL-C ( P =0.01), whereas triglycerides and apoB 100 did not contribute further information. HDL-C–related ratios were the strongest contributors to predicting CHD ( P <0.0001). Conclusions— Lower levels of HDL-C may be a key discriminator of higher CHD events among postmenopausal women. HDL-C–related ratios (such as TC/HDL-C) provide a powerful predictive tool independently of other known CHD risk factors.

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“…25,[27][28][29][30][31][32][33][34] Thus, the analyses presented are limited to C-reactive protein (CRP), hemoglobin A1C (hgA1C), and high-density lipoprotein (HDL) cholesterol.…”

Section: Blood Specimen Collection and Assaysmentioning

confidence: 99%

Neighborhood Socioeconomic Status in Relation to Serum Biomarkers in the Black Women’s Health Study

et al. 2016

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Lower neighborhood socioeconomic status (SES) is associated with higher cardiovascular disease (CVD) risk. Black women have a higher CVD risk and are more likely to live in poor neighborhoods than white women. We examined the association of neighborhood SES with several CVD biomarkers using data from the Black Women's Health Study (BWHS), a follow-up study of US black women reporting high levels of education and income. Blood specimens of 418 BWHS participants were assayed for Creactive protein (CRP), hemoglobin A1C (hgA1C), and high-density lipoprotein (HDL) cholesterol. US Census block group data were linked to the women's addresses to reflect neighborhood SES. Multivariable-adjusted mixed linear regression models that adjusted for person-level SES and for cardiovascular risk factors were used to assess CRP, hgA1C, and HDL levels in relation to quintiles of neighborhood SES. Women living in the poorest neighborhoods had the least favorable biomarker levels. As neighborhood SES increased, CRP decreased (P for trend = 0.01), hgA1C decreased (P for trend = 0.07), and HDL increased (P for trend = 0.19). These associations were present within strata of individual educational level. The present findings suggest that neighborhood environments may affect physiological processes within residents independently of individual SES.

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Relation Between Baseline and On-Treatment Lipid Parameters and First Acute Major Coronary Events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)

Cited by 500 publications

References 22 publications

White Blood Cell Count Predicts Reduction in Coronary Heart Disease Mortality With Pravastatin

White Blood Cell Count Predicts Reduction in Coronary Heart Disease Mortality With Pravastatin

Multivariate Assessment of Lipid Parameters as Predictors of Coronary Heart Disease Among Postmenopausal Women

Neighborhood Socioeconomic Status in Relation to Serum Biomarkers in the Black Women’s Health Study

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