Low-Density Lipoprotein Cholesterol Concentrations and Association of High-Sensitivity C-Reactive Protein Concentrations with Incident Coronary Heart Disease in the Multi-Ethnic Study of Atherosclerosis

Gen Min Lin; Kiang Liu; Laura A. Colangelo; Susan G. Lakoski; Russell P. Tracy; Philip Greenland

doi:10.1093/aje/kwv144

Low-Density Lipoprotein Cholesterol Concentrations and Association of High-Sensitivity C-Reactive Protein Concentrations with Incident Coronary Heart Disease in the Multi-Ethnic Study of Atherosclerosis

Gen Min Lin^*, Kiang Liu, Laura A. Colangelo, Susan G. Lakoski, Russell P. Tracy, Philip Greenland

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

28 Scopus citations

Abstract

High-sensitivity C-reactive protein (hs-CRP) has been associated with coronary heart disease (CHD) in numerous but not all observational studies, and whether low levels of low-density lipoprotein cholesterol (LDL-C) alter this association is unknown. In the Multi-Ethnic Study of Atherosclerosis (2000-2012), we prospectively assessed the association of hs-CRP concentrations with incident CHD in participants who did not receive lipid-lowering therapy, as well as in those with LDL-C concentrations less than 130 mg/dL (n = 3,106) and those with LDL-C concentrations of 130 mg/dL or greater (n = 1,716) at baseline (2000-2002). Cox proportional hazard analyses were used to assess the associations after adjustment for socioeconomic status, traditional risk factors, body mass index, diabetes, aspirin use, kidney function, and coronary artery calcium score. Log_e hs-CRP was associated with incident CHD in participants with LDL-C concentrations of 130 mg/dL or higher (hazard ratio (HR) = 1.29, 95% confidence interval (CI): 1.05, 1.60) but not in those with LDL-C concentrations less than 130 mg/dL (HR = 0.88, 95% CI: 0.74, 1.05; P for interaction = 0.003). As a whole, log_e hs-CRP was not associated with incident CHD in participants who had not received lipid-lowering therapy at baseline (HR = 1.05, 95% CI: 0.92, 1.20) and who had mean LDL-C concentrations less than 130 mg/dL. These findings suggest that LDL-C concentrations might be a moderator of the contribution of hs-CRP to CHD.

Original language	English (US)
Pages (from-to)	46-52
Number of pages	7
Journal	American journal of epidemiology
Volume	183
Issue number	1
DOIs	https://doi.org/10.1093/aje/kwv144
State	Published - Jan 1 2016

Funding

Author affiliations: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (Gen-Min Lin, Kiang Liu, Laura A. Colangelo, Philip Greenland); Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan (Gen-Min Lin); Division of Cardiology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Gen-Min Lin); Department of Internal Medicine, College of Medicine, University of Vermont, Burlington, Vermont (Susan G. Lakoski); Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Burlington, Vermont (Russell P. Tracy); and Department of Biochemistry, College of Medicine, University of Vermont, Burlington, Vermont (Russell P. Tracy). This research was supported by National Institutes of Health contracts N01-HC-95159 through N01-HC-95169. G.-M.L. was supported by a scholarship grant from the Ministry of Defense, Taiwan.

Keywords

coronary heart disease
high-sensitivity C-reactive protein
low-density lipoprotein cholesterol

ASJC Scopus subject areas

Epidemiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/aje/kwv144

Cite this

Lin, G. M., Liu, K., Colangelo, L. A., Lakoski, S. G., Tracy, R. P., & Greenland, P. (2016). Low-Density Lipoprotein Cholesterol Concentrations and Association of High-Sensitivity C-Reactive Protein Concentrations with Incident Coronary Heart Disease in the Multi-Ethnic Study of Atherosclerosis. American journal of epidemiology, 183(1), 46-52. https://doi.org/10.1093/aje/kwv144

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title = "Low-Density Lipoprotein Cholesterol Concentrations and Association of High-Sensitivity C-Reactive Protein Concentrations with Incident Coronary Heart Disease in the Multi-Ethnic Study of Atherosclerosis",

abstract = "High-sensitivity C-reactive protein (hs-CRP) has been associated with coronary heart disease (CHD) in numerous but not all observational studies, and whether low levels of low-density lipoprotein cholesterol (LDL-C) alter this association is unknown. In the Multi-Ethnic Study of Atherosclerosis (2000-2012), we prospectively assessed the association of hs-CRP concentrations with incident CHD in participants who did not receive lipid-lowering therapy, as well as in those with LDL-C concentrations less than 130 mg/dL (n = 3,106) and those with LDL-C concentrations of 130 mg/dL or greater (n = 1,716) at baseline (2000-2002). Cox proportional hazard analyses were used to assess the associations after adjustment for socioeconomic status, traditional risk factors, body mass index, diabetes, aspirin use, kidney function, and coronary artery calcium score. Loge hs-CRP was associated with incident CHD in participants with LDL-C concentrations of 130 mg/dL or higher (hazard ratio (HR) = 1.29, 95% confidence interval (CI): 1.05, 1.60) but not in those with LDL-C concentrations less than 130 mg/dL (HR = 0.88, 95% CI: 0.74, 1.05; P for interaction = 0.003). As a whole, loge hs-CRP was not associated with incident CHD in participants who had not received lipid-lowering therapy at baseline (HR = 1.05, 95% CI: 0.92, 1.20) and who had mean LDL-C concentrations less than 130 mg/dL. These findings suggest that LDL-C concentrations might be a moderator of the contribution of hs-CRP to CHD.",

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Lin, GM, Liu, K, Colangelo, LA, Lakoski, SG, Tracy, RP & Greenland, P 2016, 'Low-Density Lipoprotein Cholesterol Concentrations and Association of High-Sensitivity C-Reactive Protein Concentrations with Incident Coronary Heart Disease in the Multi-Ethnic Study of Atherosclerosis', American journal of epidemiology, vol. 183, no. 1, pp. 46-52. https://doi.org/10.1093/aje/kwv144

Low-Density Lipoprotein Cholesterol Concentrations and Association of High-Sensitivity C-Reactive Protein Concentrations with Incident Coronary Heart Disease in the Multi-Ethnic Study of Atherosclerosis. / Lin, Gen Min; Liu, Kiang; Colangelo, Laura A. et al.
In: American journal of epidemiology, Vol. 183, No. 1, 01.01.2016, p. 46-52.

Research output: Contribution to journal › Article › peer-review

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Low-Density Lipoprotein Cholesterol Concentrations and Association of High-Sensitivity C-Reactive Protein Concentrations with Incident Coronary Heart Disease in the Multi-Ethnic Study of Atherosclerosis

Abstract

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UN SDGs

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