High-density lipoprotein cholesterol as a predictor of coronary heart disease risk. The PROCAM experience and pathophysiological implications for reverse cholesterol transport
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Abstract
The incidence of coronary heart disease (CHD) was assessed via the Prospective Cardiovascular
Münster (PROCAM) study in 19,698 volunteer subjects aged between 16 and 65 years.
An adequate incidence of atherosclerotic CHD was only found in male subjects greater
than 40 years of age. The analysis and subsequent 6 year follow-up period was, therefore,
confined to 4559 male participants aged 40-64 years. In the follow-up period, 186
study participants developed atherosclerotic CHD (134 definite non-fatal myocardial
infarctions (MIs) and 52 definite atherosclerotic CHD deaths including 21 sudden cardiac
deaths and 31 fatal MIs). Univariate analysis revealed a significant association between
the incidence of atherosclerotic CHD and high-density lipoprotein cholesterol (P <
0.001), which remained after adjustment for other risk factors.