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Multiple lipid scoring system for prediction of coronary heart disease risk: application to African Americans.

TitleMultiple lipid scoring system for prediction of coronary heart disease risk: application to African Americans.
Publication TypeJournal Article
Year of Publication2006
AuthorsEverett CJ, Mainous AG, Koopman RJ, Diaz VA
JournalJ Natl Med Assoc
Date Published2006 Nov
KeywordsApolipoproteins B, Black or African American, Cholesterol, Cholesterol, HDL, Cholesterol, LDL, Coronary Artery Disease, Coronary Disease, Health Status Indicators, Humans, Lipids, Middle Aged, Predictive Value of Tests, Risk Assessment

BACKGROUND: Clinicians often obtain a panel of lipids but then only use low-density-lipoprotein (LDL) cholesterol to make clinical decisions. We previously described the multiple lipid measure, a strategy that integrates information about seven lipid measures. Our current inquiry uses the multiple lipid measure to create a scoring system and validates that system in a second cohort.

METHODS AND RESULTS: A scoring system that uses total cholesterol, high-density lipoprotein (HDL) cholesterol, LDL cholesterol and triglycerides was developed and tested. African-American participants of the Atherosclerosis Risk in Communities (ARIC) Study were used to validate the multiple lipid measure score. For nonsmokers, scores > or = 2 had a hazard ratio of 4.25 (95% CI 1.92-9.40) compared to reference scores of or = 160 mg/dl had a hazard ratio of 2.31 (95% CI 1.13-4.75). For current smokers, the best conventional lipid measure was the total cholesterol/HDL cholesterol ratio, which was similar in predictive ability to the multiple lipid measure score. However, the multiple lipid measure score predicted an additional 10% of the cohort at risk compared to the total cholesterol/HDL cholesterol ratio.

CONCLUSIONS: The use of the multiple lipid scoring system improves the assessment of incident coronary heart disease risk and may have utility for clinicians in integrating lipid values.

Alternate JournalJ Natl Med Assoc
PubMed ID17128681
PubMed Central IDPMC2569773
Grant List2 D54 HP-00023 / / PHS HHS / United States