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Blood lipid concentrations and risk of myocardial infarction

S Mediene-Benchekor, T Brousseau, F Richard

    Lancet (London, England)
    |October 9, 2001
    PubMed

    Insights

    Algerian myocardial infarction patients had lower lipid levels than Western thresholds. Cholesterol ratios, not absolute levels, consistently estimated cardiovascular risk across populations, questioning current prevention guidelines.

    Area of Science:

    • Cardiology
    • Lipidology
    • Public Health

    Background:

    • Western coronary heart disease prevention relies on plasma lipid thresholds.
    • Algerian populations exhibit lower lipid concentrations, potentially excluding them from preventive strategies.
    • Myocardial infarction risk assessment needs population-specific considerations.

    Purpose of the Study:

    • To investigate plasma lipid profiles in Algerian myocardial infarction patients and controls.
    • To compare Algerian lipid profiles and cardiovascular risk with French and Irish cohorts.
    • To evaluate the utility of traditional lipid thresholds versus cholesterol ratios for risk assessment in diverse populations.

    Main Methods:

    • Case-control study in Algeria involving 67 myocardial infarction patients and 70 controls.
    • Analysis of plasma lipid profiles, including total cholesterol, LDL cholesterol, and HDL cholesterol.
    • Comparison of findings with existing data from similar studies in France and Ireland.

    Main Results:

    • Increased total cholesterol and LDL cholesterol, and decreased HDL cholesterol, were associated with myocardial infarction risk in Algeria.
    • Lipid concentrations in Algerian patients rarely met established Western threshold values for high risk.
    • Cholesterol ratios (total/HDL, LDL/HDL) provided consistent cardiovascular risk estimates across Algerian, French, and Irish populations.

    Conclusions:

    • Traditional lipid concentration thresholds may be inadequate for cardiovascular risk assessment in populations with inherently lower lipid levels, such as in Algeria.
    • Cholesterol ratios offer a more reliable and comparable measure of cardiovascular risk across different ethnic and geographical groups.
    • Re-evaluation of cardiovascular risk prevention strategies and lipid thresholds is warranted for populations with low plasma lipid concentrations.

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