Abstract 4099: Elevated Campesterol Serum Levels - a Significant Predictor of Incident Myocardial Infarction: Results of the Population-based MONICA/KORA Follow-up Study 1994 to 2005
The increasing use of “functional foods” supplemented with plant sterols to lower serum cholesterol levels and on the other hand the discovery of the rare ABCG5/G8 mutation resulting in high phytosterol levels and premature atherosclerosis has renewed the clinical interest on the role of plasma phytosterols in coronary artery disease. It is still unclear if plasma phytosterol levels in the general population may associated with CAD risk. However, some recent reports support this consideration. Therefore, population studies examining the relationship of phytosterol levels to coronary events are necessary to evaluate any contributions of phytosterols to CAD risk. The aim of our study was to assess the association between the serum levels of the phytosterol campesterol and the 10 year risk of incident myocardial infarction in initially healthy middle-aged men from Southern Germany with no myocardial infarction in medical history. Serum concentrations of total campesterol and other sterols were determined using a novel high-throughput LC-MS/MS platform. The study population included 1186 male participants (age at baseline 35–64 years) which were randomly sampled from the general population of the Southern German region of Augsburg in 1994/95 and followed until 2004/2005. During this period 49 men suffered from either a fatal or non-fatal acute CHD event. In a Cox Proportional-Hazards model, after multivariable adjustment for established cardiovascular risk factors the hazard ratio (HR) for incident acute myocardial infarction (including sudden coronary deaths) was 2.38 (95% CI, 0.64–6.01) for third quartile (5.70–7.26 mg/l) and 3.00 (95% CI, 1.16–7.78) for the fourth quartile (>= 7.27 mg/l) of total campesterol in comparison to its first quartile (< 4.42 mg/l), the test on linearity of the association was significant (p<0.001). Our results of a large prospective population-based cohort analysis demonstrate for the first time that plasma campesterol is an independent and highly significant metabolic marker indicating an increased risk for incident myocardial infarction in middle aged men. Further research is needed to elucidate the pathophysiological mechanisms of this observation.