Relationship of lipid oxidation with subclinical atherosclerosis and 10-year coronary events in general population

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• 作者：Miquel G贸mez ; Joan Vila ; Roberto Elosua ; Llu铆s Molina ; Jordi Bruguera ; Joan Sala ; Rafel Masi脿 ; Maria Isabel Covas ; Jaume Marrugat ; Montserrat Fit贸
• 关键词：Cohort study ; Biomarkers ; Intima-media thickness ; Oxidation ; Atherosclerosis ; Ankle-brachial index
• 刊名：Atherosclerosis
• 出版年：January, 2014
• 年：2014
• 卷：232
• 期：1
• 页码：134-140
• 全文大小：950 K

文摘

Objectives

To assess 1) the association of lipid oxidation biomarkers with 10-year coronary artery disease (CAD) events and subclinical atherosclerosis, and 2) the reclassification capacity of these biomarkers over Framingham-derived CAD risk functions, in a general population.

Methods

Within the framework of the REGICOR study, 4782 individuals aged between 25 and 74 years were recruited in a population-based cohort study. Follow-up of the 4042 who met the eligibility criteria was carried out. Plasma, circulating oxidized low-density lipoprotein (oxLDL) and oxLDL antibodies (OLAB) were measured in a random sample of 2793 participants.

End-points included fatal and non-fatal acute myocardial infarction (AMI) and angina. Carotid intima-media thickness (IMT) in the highest quintile and ankle-brachial index <0.9 were considered indicators of subclinical atherosclerosis.

Results

Mean age was 50.0 (13.4) years, and 52.4% were women. There were 103 CAD events (34 myocardial infarction, 43 angina, 26 coronary deaths), and 306 subclinical atherosclerosis cases. Oxidized LDL was independently associated with higher incidence of CAD events (HR聽=聽1.70; 95% Confidence Interval: 1.02-2.84), but not with subclinical atherosclerosis. The net classification index of the Framingham-derived CAD risk function was significantly improved when ox-LDL was included (NRI聽=聽14.67% [4.90; 24.45], P聽=聽0.003). No associations were found between OLAB and clinical or subclinical events. The reference values for oxLDL and OLAB are also provided (percentiles).

Conclusions

OxLDL was independently associated with 10-year CAD events but not subclinical atherosclerosis in a general population, and improved the reclassification capacity of Framingham-derived CAD risk functions.