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Relative Contribution of Lipids and Apolipoproteins to Incident Coronary Heart Disease and Ischemic Stroke: The PRIME Study

Canouï-Poitrine F.a, b · Luc G.c · Bard J.-M.d · Ferrieres J.e · Yarnell J.j · Arveiler D.f · Morange P.g · Kee F.j · Evans A.j · Amouyel P.h · Ducimetiere P.i · Empana J.-P.a
aINSERM, U970, Paris Cardiovascular Research Center, Université Paris Descartes, UMR-S970, Paris, bHospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Université Lyon 1, Lyon, cDepartment of Atherosclerosis, INSERM, U545, Institut Pasteur de Lille, Lille 2 University, Lille, dFaculté de Pharmacie, Université de Nantes, Nantes, eThe Toulouse MONICA Project, INSERM, U558, Département d’Epidémiologie, Université Paul Sabatier, Toulouse, fThe Strasbourg MONICA Project, Laboratoire d’Epidémiologie et de Santé Publique, EA 3430, and Université de Strasbourg, Strasbourg, gINSERM, U626, Laboratory of Hematology, La Timone Hospital, Marseille, hThe Lille MONICA Project, INSERM, U744, Institut Pasteur de Lille, Université Lille Nord de France, Lille, and iINSERM, Université Paris Sud-XI, Paris, France; jThe UKCRC Center of Excellence for Public Health, The Queen’s University, Belfast, UK Cerebrovasc Dis 2010;30:252–259 (DOI:10.1159/000319067)


Aim: To compare within the same cohort the association of a large panel of lipids with the risk of incident coronary heart disease (CHD) and ischemic stroke events in participants of the Prospective Epidemiological Study of Myocardial Infarction. Methods: In this binational (Northern Ireland and France) prospective cohort, we considered 9,711 men aged 50–59 years free of CHD and stroke at baseline (1991–1993). The hazard ratios of each lipid marker for CHD and ischemic stroke events were estimated in separate Cox proportional hazard models adjusted for age, study center, systolic blood pressure, antihypertensive treatment, current smoking status, body mass index and diabetes. Results: After 10 years of follow-up, 635 men had a first CHD and 98 a first ischemic stroke event. Total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, triglycerides, apolipoprotein (Apo) A1 and Apo B100, their ratios and lipoprotein (a) [Lp(a)] were all significantly predictive of future CHD. Associations with ischemic stroke followed the same trend as for CHD, but with lower strength, and none were statistically significant. However, none of the differences between the hazard ratios for CHD and for ischemic stroke were statistically significant. Conclusions: In healthy, middle-aged men, total-C, HDL-C, LDL-C, non-HDL-C, triglycerides, Apo A1 and Apo B100, their ratios and Lp(a) are, if anything, weak predictors of ischemic stroke events over a 10-year period.


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