Lipoprotein components and risk of congestive heart failure in 84 740 men and women in the Apolipoprotein MOrtality RISk study (AMORIS)

Few studies have analysed the influence of lipoprotein components (LC) on the development of congestive heart failure (HF) in large healthy populations. We examined LC together with glucose, haptoglobin (Hp), and uric acid (UA) as risk factors for HF in the Apolipoprotein MOrtality RISk (AMORIS) study. We also explored the possible interaction between these factors and the apolipoprotein B to apolipoprotein A-1 ratio (apoB/apoA-1) in HF. This was a prospective study of HF conducted over 11.8 years through links with the Swedish hospital discharge and mortality registers. Lipoprotein components and other risk factors were measured in 84 740 men and women during health check-ups. All LC were strongly associated with HF per gender adjusted for risk factors. Relationships were stronger for men than for women. Among LC the apoB/apoA-1 ratio was the strongest risk factor for HF in men and triglycerides (TG) in women, but differences in strength were not large. The Hp and UA added predictive information to that of the apoB/apoA-1 ratio, but glucose did not. There was no detectable interaction (synergistic effects) on relative risk between apoB/apoA-1 and these three additional factors. Over and above adjustment factors, the apoB/apoA-1 ratio and TG were the most predictive of the LC, but all LC were highly significantly related to the development of HF.