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Stroke mortality and the apoB/apoA-I ratio: results of the AMORIS prospective study

G Walldius1, A H Aastveit, I Jungner

  • 1King Gustaf V Research Institute, Karolinska Institute, Stockholm, Sweden. goran.walldius@astrazeneca.com

Journal of Internal Medicine
|February 16, 2006
PubMed

Insights

The apoB/apoA-I ratio, reflecting cholesterol balance, is a strong predictor of stroke risk, similar to its association with heart attacks. This ratio is a reliable marker for most ischemic events.

Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Stroke Research

Background:

  • Low-density lipoprotein (LDL) cholesterol is a known risk factor for myocardial infarction but not stroke.
  • The relationship between stroke risk and the balance of proatherogenic apolipoprotein B (apoB) and antiatherogenic apolipoprotein A-I (apoA-I) particles is not well-established.

Purpose of the Study:

  • To investigate if the apoB/apoA-I ratio, representing cholesterol balance, is associated with stroke risk.
  • To compare the predictive power of the apoB/apoA-I ratio with traditional lipid ratios for stroke.

Main Methods:

  • Prospective analysis of over 175,000 individuals (98,722 men, 76,831 women).
  • Examination of relationships between fatal stroke types, lipid fractions, apoB, apoA-I, and the apoB/apoA-I ratio.
  • Comparison of stroke risk with other ischemic and non-ischemic fatalities.

Main Results:

  • High apoB and low apoA-I levels were significantly associated with stroke risk.
  • The apoB/apoA-I ratio was a stronger predictor of stroke than total/HDL and LDL/HDL cholesterol ratios.
  • The apoB/apoA-I ratio showed a linear relationship with stroke risk, particularly for ischemic stroke, and was not linked to cancer risk.

Conclusions:

  • The apoB/apoA-I ratio is linked to fatal stroke risk, mirroring its association with myocardial infarction and other ischemic events.
  • The apoB/apoA-I ratio serves as a robust and specific biomarker for nearly all ischemic events.
  • This ratio provides valuable insight into cholesterol balance and cardiovascular risk.
Abstract

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