Abstract 12141: ApoE-HDL Cholesterol Predicts Incident Cardiovascular Events: Aric Study

Abstract

Background: ApoE-HDL-C, a subfraction of HDL-C that contains ApoE, is thought to be cardioprotective via its inhibition of arterial stiffening and its role in reverse cholesterol transport. Objective: We examined the relationship between ApoE- HDL-C and incident cardiovascular events in the biracial Atherosclerosis Risk in Communities (ARIC) study. Methods: ApoE-HDL-C was measured in 9,258 ARIC participants using a novel automated homogeneous assay (Denka Seiken). The association between ApoE-HDL-C and HDL-C with incident cardiovascular events was assessed using Cox proportional hazard regression models. Covariates included age, race, gender, race, BMI, systolic blood pressure, use of anti-hypertensive medications, diabetes, smoking status, total cholesterol and triglycerides. Results: Mean ApoE-HDL-C and HDL-C levels were 5.06 ± 1.79 mg/dL and 51.10 ± 16.74 mg/dL, respectively. ApoE-HDL-C comprised roughly 10% of total HDL-C levels. ApoE-HDL-C levels were higher in non-diabetics, women and African Americans and showed strong positive correlations with HDL-C and total cholesterol levels. Both apoE-HDL-C and HDL-C were associated with incident CVD, driven mainly by CHD (Table 1). Each 10 mg/dL increase in HDL-C levels was associated with a decreased risk of incident CVD after multivariate adjustment (HR 0.89, 95% CI 0.85, 0.93, p<0.001). A 1 mg/dL increase in ApoE-HDL-C was associated with a decreased risk of incident CVD after similar multivariate adjustment (HR 0.91, 95% CI 0.88, 0.95, p<0.001). Conclusion: ApoE-HDL-C predicts incident CVD similarly to HDL-C in the biracial ARIC cohort.