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Gómez M, Vila J, Elosua R, Molina L, Bruguera J, Sala J, Masià R, Covas MI, Marrugat J, Fitó M. Relationship of lipid oxidation with subclinical atherosclerosis and 10-year coronary events in general population. Atherosclerosis 2013; 232:134-40. [PMID: 24401227 DOI: 10.1016/j.atherosclerosis.2013.10.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 10/10/2013] [Accepted: 10/23/2013] [Indexed: 10/26/2022]
Abstract
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 = 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 = 14.67% [4.90; 24.45], P = 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.
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Affiliation(s)
- Miquel Gómez
- Cardiology Department, Parc de Salut Mar, Barcelona, Spain; Medicine Department, Autonomous University of Barcelona, Barcelona, Spain; Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Joan Vila
- Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular and Genetic Epidemiology Research Group (EGEC, REGICOR Study Group), IMIM, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Roberto Elosua
- Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular and Genetic Epidemiology Research Group (EGEC, REGICOR Study Group), IMIM, Spain
| | - Lluís Molina
- Cardiology Department, Parc de Salut Mar, Barcelona, Spain; Medicine Department, Autonomous University of Barcelona, Barcelona, Spain; Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Jordi Bruguera
- Cardiology Department, Parc de Salut Mar, Barcelona, Spain; Medicine Department, Autonomous University of Barcelona, Barcelona, Spain; Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Joan Sala
- Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiology Department, Hospital Josep Trueta, Girona, Spain
| | - Rafel Masià
- Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiology Department, Hospital Josep Trueta, Girona, Spain
| | - Maria Isabel Covas
- Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular Risk and Nutrition Research Group (CARIN, REGICOR Study Group), IMIM, Spain; CIBER of Obesity Physiopathology and Nutrition (CIBEROBN), Spain
| | - Jaume Marrugat
- Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular and Genetic Epidemiology Research Group (EGEC, REGICOR Study Group), IMIM, Spain
| | - Montserrat Fitó
- Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Cardiovascular Risk and Nutrition Research Group (CARIN, REGICOR Study Group), IMIM, Spain; CIBER of Obesity Physiopathology and Nutrition (CIBEROBN), Spain.
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