Abstract

BACKGROUND: The measurement of plasma apolipoproteins (APO) has been proposedfor predicting the risk of cardiovascular diseases. However, the association between APOs and strokeis not well defined. MATERIAL/METHODS: We evaluated the association between plasma concentrations ofAPO A-1 and APO B with a physician diagnosis of stroke (n=153), and electrocardiogram evidence or physiciandiagnosis of myocardial infarction (n=379), in a nationally representative sample of 3,696 US adultsaged >40 years who participated in the Third National Health and Nutrition Examination Survey. Multivariatelogistic regression analyses were used to investigate these relationships. RESULTS: After adjusting fordifferences in age, gender, race/ethnicity, education, hypertension, cholesterol, body mass index, andcigarette smoking, the upper quartile of APO A-1 (> or = 161 mg/dl) when compared with the lowest quartile( or = 1.59 when compared witha ratio < or = 1.04 was associated with a decreased likelihood of myocardial infarction (OR, 0.3; 95%CI, 0.2-0.6); and stroke (OR 0.4, 95% CI, 0.2-1.0). CONCLUSIONS: Higher APO A-1 concentrations were associatedwith a decreased likelihood for myocardial infarction but not for stroke. The APO A-1 to B ratio wasinversely associated with both myocardial infarction and stroke and may be an important protective clinicalmarker for atherosclerosis.

Keywords: Apolipoprotein A-I, Apolipoproteins B, Arteriosclerosis, Cerebrovascular Accident, Electrocardiography, Myocardial Infarction, Odds Ratio, Risk Factors