Dyslipidemia boosts myocardial infarction risk in those with chronic kidney disease

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By David Liu, PHD

Monday Nov 19, 2012 (foodconsumer.org) -- Patients with chronic kidnet disease may want to carefully watch their cholesterol and blood fat as a new study showed that if they also suffered dyslipidemia, they would have an increased risk for myocardial infarction, which is also known as heart attack.

Martin J. Holzmann of Karolinska University Hospital in Stockholm, Sweden conducted the study to examine whether dyslipidemia which means high cholesterol and high blood fat in developed countries affects the risk of myocardial infarction in patients with chronic kidney disease.

In the study of 142,394 individuals, chronic kidney disease was defined as having the glomerular filtration rate at 15 to 60 mL/min/1.73 m2.  Participants were stratified into two groups, one with chronic kidney disease and the other without.  Participants were followed for 12 years and 5,466 cases of myocardial infarction were identified

Among participants without chronic kidney disease, those in the highest quartile of the apolipoprotein B/apo!-1 ratio were 188 percent more likely to suffer myocardial infarction, compared to those in the lowest quartile.   Among participants with chronic kidney disease, the highest quartile of the ratio was associated with 235 percent increased risk for mycardial infarction.

Smilarly, those without chronic kidney disease in the highest quartile of the ratio of the total cholesterol to high density lipoprotein cholesterol were 213 percent more likely to experience myocardial infarction, compared with those in the lowest quartile.  Those with kidney disease in the highest quartile of the ratio were 254 percent more likely to suffer the cardiovascular event, compared to those in the lowest quartile.

The researchers also analysed the data and found the ratio of apoB/apoA-1 is a better preidctor for the risk of myocardial infarction than the lipids.

They concluded "The ratio of apoB/apoA-1, the ratio of total cholesterol/HDL cholesterol, and non-HDL cholesterol were all strong predictors of myocardial infarction, both among subjects with and without renal dysfunction, with a possible advantage for the apoB/apoA-1 ratio."

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