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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2002;22:1155.)
© 2002 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Value of HDL Cholesterol, Apolipoprotein A-I, Lipoprotein A-I, and Lipoprotein A-I/A-II in Prediction of Coronary Heart Disease

The PRIME Study

Gérald Luc; Jean-Marie Bard; Jean Ferrières; Alun Evans; Philippe Amouyel; Dominique Arveiler; Jean-Charles Fruchart; Pierre Ducimetière on behalf of the PRIME Study Group^*

From the Department of Atherosclerosis (G.L., J.-M.B., J.-C.F.), INSERM UR545, Institut Pasteur de Lille, and University Lille II, Lille, France; the Toulouse Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project (J.F.), INSERM U518, Department of Epidemiology, Paul Sabatier-Toulouse Purpan University, Toulouse, France; the Belfast MONICA Project (A.E.), Department of Epidemiology and Public Health, The Queen’s University of Belfast, Belfast, Northern Ireland; the Lille MONICA Project (P.A.), INSERM U508, Institut Pasteur de Lille, Lille, France; the Strasbourg MONICA Project (D.A.), Department of Epidemiology and Public Health, Faculty of Medicine, Strasbourg, France; and the Coordinating Center (P.D.), INSERM U258, Hôpital Paul Brousse, Villejuif, France.

Correspondence to Gérald Luc, Department of Atherosclerosis, SERLIA-INSERM UR545, Institut Pasteur de Lille, 1, rue du Professeur Calmette, 59019 Lille Cedex, France. E-mail Gerald.Luc{at}pasteur-lille.fr

Objective— We have examined the association between the incidence of coronary heart disease (CHD) and plasma high density lipoprotein (HDL) cholesterol, apolipoprotein A-I (apoA-I), and 2 HDL fractions, lipoprotein A-I and lipoprotein A-I:A-II.

Methods and Results— These parameters were measured in subjects recruited in France and in Northern Ireland in the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study, a prospective cohort study. Among the subjects free of CHD on entry, 176 in France and 113 in Northern Ireland suffered an ischemic attack (CHD patients) during the 5-year follow-up, whereas 6612 French and 2172 Northern Irish men showed no CHD symptoms (CHD-free subjects). All 4 HDL parameter levels were lower in CHD patients than in CHD-free subjects. After the cohort was divided into quintiles based on the distribution of HDL parameter levels, a significant (P<0.0001) linear increase in relative risk was observed for each HDL parameter level. However, regression logistic analyses showed that apoA-I was the strongest predictor (more powerful than HDL cholesterol) and that lipoprotein A-I and lipoprotein A-I:A-II did not supplement apoA-I in predicting CHD.

Conclusions— Among the parameters related to HDL, apoA-I appears to be the strongest independent risk factor.

Key Words: prospective study • apolipoprotein A-I • lipoprotein A-I • coronary heart disease

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