Improving Prediction of Ischemic Cardiovascular Disease in the General Population Using Apolipoprotein B

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Abstract
Background— Apolipoprotein B (apoB) levels predict fatal myocardial infarction. Whether apoB also predicts nonfatal ischemic cardiovascular events is unclear. We tested the following hypotheses: apoB predicts ischemic cardiovascular events, and apoB is a better predictor of ischemic cardiovascular events than low-density lipoprotein cholesterol. Methods and Results— We studied 9231 asymptomatic women and men from the Danish general population followed prospectively for 8 years and observed the following incident events: ischemic heart disease 591, myocardial infarction 278, ischemic cerebrovascular disease 313, ischemic stroke 229, and any ischemic cardiovascular event 807. Women with apoB in the upper versus the lower tertile had hazard ratios for ischemic heart disease of 1.8 (1.2 to 2.5), for myocardial infarction 2.6 (1.4 to 4.7), and for any ischemic cardiovascular event 1.8 (1.3 to 2.3), and men had hazard ratios for ischemic heart disease of 1.9 (1.5 to 2.6), for myocardial infarction 2.4 (1.5 to 3... Apolipoprotein B (apoB) levels predict fatal myocardial infarction in men. Whether apoB also predicts nonfatal ischemic cardiovascular events is unclear. In the present study we show that apoB level is a predictor of an increased risk of: ischemic heart disease and myocardial infarction not only in men but also in women; ischemic cerebrovascular disease and ischemic stroke in women; and any ischemic cardiovascular event in both genders.