• Brigitte M Sondermeijer, Jamal S Rana, Benoit J Arsenault, Prediman K Shah, John J P Kastelein, Nicholas J Wareham, S Matthijs Boekholdt, and Kay-Tee Khaw.
• Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
• Eur. J. Clin. Invest. 2013 Oct 1; 43 (10): 1009-15.

BackgroundThere is an ongoing debate about the performance of non-high-density lipoprotein cholesterol (non-HDL-C) compared with apolipoprotein B (apo B) in the prediction of coronary heart disease (CHD) risk. Therefore, we compared the associations between non-HDL-C and apo B in regard to CHD among apparently healthy Western European individuals.DesignIn the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk prospective population study, 25,639 men and women aged 45-79 years were followed for 11·4 ± 2·8 years. Those with diabetes or prevalent CHD at baseline were excluded. A total of 2066 (12·1%) participants developed CHD during 195 692 person-years follow-up.ResultsThe multivariable-adjusted hazard ratio [HR] of future CHD per one standard deviation increase was 1·22 [95% confidence interval (CI): 1·17-1·27] for LDL-C, 1·26 (95% CI 1·20-1·31) for non-HDL-C and 1·19 (95% CI 1·14-1·24) for apo B, respectively. The multivariable-adjusted HR of future CHD in the highest quartile LDL-C was 1·67 (95% CI: 1·47-1·91). For non-HDL-C and apo B, these respective HRs were 1·87 (95% CI: 1·62-2·15) and 1·56 (95% CI: 1·36-1·78). Kaplan-Meier survival analyses showed that there was incremental and comparable increase in risk of CHD with increasing quartiles of both non-HDL-C and apo B.ConclusionsIn this prospective study, non-HDL-C and apo B were comparable in their ability to predict risk of future CHD.© 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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