5 Steps to prevent Heart Disease

Saturday, April 28, 2018

Questionable use of Ridker reference in Eat Rich Live Long #2

Reference used on p 262 in Eat Rich Live Long

The data below from the article sited on p262 contradicts the heading of the chapter 
ApoB/ApoA1 had the worse predictive value of the ratios. 

 APOB/APOA1: The MASTER RATIO. 
Conclusion of article:
"NON-HDLc & ratio of TC/ HDLc were as good as or better than apolipoprotein fractions in prediction of future CVE." 

Data from Article
After adjustment for age, smoking status, blood pressure, diabetes, and body mass index, the HRs (hazard ratios)for future cardiovascular events for those in the extreme quintiles were 
1.62 (95% CI, 1.17-2.25) for LDL-C, 
1.75 (95% CI, 1.30-2.38) for apolipoprotein A-I,
 2.08 (95% CI, 1.45-2.97) for total cholesterol,
 2.32 (95% CI, 1.64-3.33) for HDL-C,
 2.50 (95% CI, 1.68-3.72) for apolipoprotein B(100),
 2.51 (95% CI, 1.69-3.72) for non-HDL-C, 
and 2.98 (95% CI, 1.90-4.67) for high-sensitivity CRP (P<.001 for trend across all quintiles).
 The HRs for the lipid ratios were
 3.01 (95% CI, 2.01-4.50) for apolipoprotein B(100) to apolipoprotein A-I,
 3.18 (95% CI, 2.12-4.75) for LDL-C to HDL-C,
 3.56 (95% CI, 2.31-5.47) for apolipoprotein B(100) to HDL-C, and
 3.81 (95% CI, 2.47-5.86) for the total cholesterol to HDL-C (P<.001 for trend across all quintiles). 
The correlation coefficients between high-sensitivity CRP and the lipid parameters ranged from -0.33 to 0.15, and the clinical cut points for CRP of less than 1, 1 to 3, and higher than 3 mg/L provided prognostic information on risk across increasing levels of each lipid measure and lipid ratio.

CONCLUSIONS:

Non-HDL-C and the ratio of total cholesterol to HDL-C were as good as or better than apolipoprotein fractions in the prediction of future cardiovascular events. After adjustment for age, blood pressure, smoking, diabetes, and obesity, high-sensitivity CRP added prognostic information beyond that conveyed by all lipid measures.

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