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European Journal of Heart Failure Advance Access originally published online on October 3, 2009
European Journal of Heart Failure 2009 11(11):1036-1042; doi:10.1093/eurjhf/hfp129
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Lipoprotein components and risk of congestive heart failure in 84 740 men and women in the Apolipoprotein MOrtality RISk study (AMORIS)

Ingar Holme1,*, Are H. Aastveit2, Niklas Hammar3,4, Ingmar Jungner5 and Göran Walldius6,7

1 Department of Preventive Cardiology, Centre of Preventive Medicine, Oslo University Hospital, Ulleval, Oslo N-0407, Norway
2 Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Aas, Norway
3 Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
4 AstraZeneca R&D, Södertälje, Sweden
5 Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden
6 King Gustaf V Research Institute, Karolinska Institutet, Stockholm, Sweden
7 AstraZeneca Sverige, Södertalje, Sweden

* Corresponding author. Tel: +47 22 11 79 27/+47 91 32 55 42, Fax: +47 22 11 99 75, Email: ingar.holme{at}uus.no


   Abstract

Aims: Few studies have analysed the influence of lipoprotein components (LC) on the development of congestive heart failure (HF) in large healthy populations. We examined LC together with glucose, haptoglobin (Hp), and uric acid (UA) as risk factors for HF in the Apolipoprotein MOrtality RISk (AMORIS) study. We also explored the possible interaction between these factors and the apolipoprotein B to apolipoprotein A-1 ratio (apoB/apoA-1) in HF.

Methods and results: This was a prospective study of HF conducted over 11.8 years through links with the Swedish hospital discharge and mortality registers. Lipoprotein components and other risk factors were measured in 84 740 men and women during health check-ups. All LC were strongly associated with HF per gender adjusted for risk factors. Relationships were stronger for men than for women. Among LC the apoB/apoA-1 ratio was the strongest risk factor for HF in men and triglycerides (TG) in women, but differences in strength were not large. The Hp and UA added predictive information to that of the apoB/apoA-1 ratio, but glucose did not. There was no detectable interaction (synergistic effects) on relative risk between apoB/apoA-1 and these three additional factors.

Conclusion: Over and above adjustment factors, the apoB/apoA-1 ratio and TG were the most predictive of the LC, but all LC were highly significantly related to the development of HF.

Key Words: Apolipoprotein B • Apolipoprotein A-1 • Heart failure • Inflammation • Lipoproteins • Oxidation

Received June 3, 2009; Revised June 24, 2009; Accepted August 19, 2009


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