TY - JOUR
T1 - Race-ethnic differences in the association between lipid profile components and risk of myocardial infarction
T2 - The Northern Manhattan Study
AU - Willey, Joshua Z.
AU - Rodriguez, Carlos J.
AU - Carlino, Richard F.
AU - Moon, Yeseon Park
AU - Paik, Myunghee C.
AU - Boden-Albala, Bernadette
AU - Sacco, Ralph L.
AU - Ditullio, Marco R.
AU - Homma, Shunichi
AU - Elkind, Mitchell S.V.
N1 - Funding Information:
The Northern Manhattan Study is a population-based study designed to evaluate the impact of medical, socioeconomic, and other risk factors on the incidence of vascular disease in a stroke-free multiethnic community cohort. Participants were identified by dual-frame random digit dialing in Northern Manhattan as previously described 9 and were eligible if they met the following criteria: (1) had never been diagnosed with a stroke; (2) were >39 years old; and (3) resided in Northern Manhattan for ≥3 months in a household with a telephone. Preexisting CHD was ascertained via questionnaires capturing self-reported MI, angina, or prior cardiac revascularization. The study was approved by the institutional review boards at Columbia University Medical Center. All participants gave informed consent to participate in the study. The study was funded by the National Institutes of Health (NINDSR37NS29993). The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the manuscript, and its final contents.
PY - 2011/5
Y1 - 2011/5
N2 - Objective: The aim of this study was to explore race-ethnic differences in the association between plasma lipid components and risk of incident myocardial infarction (MI). Design/methods: As part of the Northern Manhattan Study, 2,738 community residents without cardiovascular disease were prospectively evaluated. Baseline fasting blood samples were collected, and lipid panel components were analyzed as continuous and categorical variables. Cox proportional hazards models were used to calculate HRs and 95% CIs for incident MI after adjusting for demographic and cardiovascular risk factors. Results: The mean age was 68.8 ± 10.4 years; 36.7% were men. Of the participants, 19.9% were non-Hispanic white; 24.9%, non-Hispanic black; and 52.8%, Hispanic (>80% from the Caribbean). Hispanics had lower mean high-density lipoprotein cholesterol (HDL-C) and higher triglycerides (TG)/HDL-C. During a mean 8.9 years of follow-up, there were 163 incident MIs. In the whole cohort, all lipid profile components were associated with risk of MI in the expected directions. However, HDL-C (adjusted HR per 10 mg/dL increase 0.93, 95% CI 0.76-1.12) and TG/HDL-C >2 (adjusted HR 0.89, 95% CI 0.51-1.55) were not predictive of MI among Hispanics but were predictive among non-Hispanic blacks and whites. Triglycerides/HDL-C per unit increase was associated with an 8% higher risk of MI among Hispanics (adjusted HR 1.08, 95% CI 1.04-1.12). Conclusions: In Hispanics, low HDL-C and TG/HDL-C >2 were not associated with MI risk. Our data suggest that a different TG/HDL ratio cutoff may be needed among Hispanics to predict MI risk.
AB - Objective: The aim of this study was to explore race-ethnic differences in the association between plasma lipid components and risk of incident myocardial infarction (MI). Design/methods: As part of the Northern Manhattan Study, 2,738 community residents without cardiovascular disease were prospectively evaluated. Baseline fasting blood samples were collected, and lipid panel components were analyzed as continuous and categorical variables. Cox proportional hazards models were used to calculate HRs and 95% CIs for incident MI after adjusting for demographic and cardiovascular risk factors. Results: The mean age was 68.8 ± 10.4 years; 36.7% were men. Of the participants, 19.9% were non-Hispanic white; 24.9%, non-Hispanic black; and 52.8%, Hispanic (>80% from the Caribbean). Hispanics had lower mean high-density lipoprotein cholesterol (HDL-C) and higher triglycerides (TG)/HDL-C. During a mean 8.9 years of follow-up, there were 163 incident MIs. In the whole cohort, all lipid profile components were associated with risk of MI in the expected directions. However, HDL-C (adjusted HR per 10 mg/dL increase 0.93, 95% CI 0.76-1.12) and TG/HDL-C >2 (adjusted HR 0.89, 95% CI 0.51-1.55) were not predictive of MI among Hispanics but were predictive among non-Hispanic blacks and whites. Triglycerides/HDL-C per unit increase was associated with an 8% higher risk of MI among Hispanics (adjusted HR 1.08, 95% CI 1.04-1.12). Conclusions: In Hispanics, low HDL-C and TG/HDL-C >2 were not associated with MI risk. Our data suggest that a different TG/HDL ratio cutoff may be needed among Hispanics to predict MI risk.
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U2 - 10.1016/j.ahj.2011.01.018
DO - 10.1016/j.ahj.2011.01.018
M3 - Article
C2 - 21570518
AN - SCOPUS:79955901294
SN - 0002-8703
VL - 161
SP - 886
EP - 892
JO - American heart journal
JF - American heart journal
IS - 5
ER -
