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The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases

  • Cardiovascular Disease
  • Published:
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Abstract

Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.

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Authors and Affiliations

    Consortia

    The Emerging Risk Factors Collaboration

    Additional information

    Authors/collaborators in the Emerging Risk Factors Collaboration are listed at the end of this article.

    Appendices

    List of Authors (Appendix 1 lists the study acronyms)

    Authors/Writing Committee: J Danesh, S Erqou, M Walker, SG Thompson.

    Authors/Collaborators: AFTCAPS: R Tipping; ALLHAT: C Ford, S. Pressel; AMORIS: G Walldius, I Jungner; ARIC: AR Folsom, LE Chambless; BHS: M Knuiman; BRHS: PH Whincup, SG Wannamethee, RW Morris; BRUN: J Willeit, S Kiechl, P Santer, A Mayr; BUPA: N Wald; BWHHS: S Ebrahim, DA Lawlor; CaPS: JWG Yarnell, J Gallacher; CASTEL: E Casiglia, V Tikhonoff; CHARL: PJ Nietert, SE Sutherland, DL Bachman, JE Keil; CHS: M Cushman, BM Psaty, RP Tracy (see http://chs-nhlbi.org for acknowledgements); COPEN: A Tybjærg-Hansen, BG Nordestgaard, R Frikke-Schmidt; CUORE: S Giampaoli, L Palmieri, S Panico, D Vanuzzo, L Pilotto; DUBBO: L Simons, J McCallum, Y Friedlander; EAS: FGR Fowkes, AJ Lee, FB Smith; EPESEBOS: J Taylor, J Guralnik, C Phillips; EPESEIOW: R Wallace, J Guralnik, C Phillips; EPESENCA: D Blazer, J Guralnik, C Phillips; EPESENHA: C Phillips, J Guralnik; EPICNOR: KT Khaw; FIA: JH Jansson; FINE_IT: C Donfrancesco, S Giampaoli; FINRISK92, FINRISK97: V Salomaa, K Harald, P Jousilahti, E Vartiainen; FLETCHER: M Woodward; FRAMOFF: RB D’Agostino, PA Wolf, RS Vasan, MJ Pencina; FRICVE: arochapinango@ono.com; GLOSTRUP: EM Bladbjerg, T Jorgensen, L Moller, J Jespersen; GOH: R Dankner, A Chetrit, F Lubin; GOTO33, GOTO43: A Rosengren, L Wilhelmsen, G Lappas, H Eriksson; GOTOW: C Bjorkelund; GRIPS: P Cremer, D Nagel; HELSINAG: R Tilvis, T Strandberg; HONOLULU: B Rodriguez; HOORN: LM Bouter, RJ Heine, JM Dekker, G Nijpels, CDA Stehouwer; HPFS: E Rimm, J Pai; IKNS: S Sato, H Iso, A Kitamura, H Noda; ISRAEL: U Goldbourt; KARELIA: V Salomaa, K Harald, P Jousilahti, E Vartiainen; KIHD: JT Salonen, K Nyyssönen, T-P Tuomainen; LASA: D Deeg, JL Poppelaars; LEADER: T Meade, J Cooper; MALMO: B Hedblad, G Berglund, G Engstrom; MOGERAUG1, MOGERAUG2, MOGERAUG3: A Döring, W Koenig, C Meisinger, W. Mraz; MOSWEGOT: L Wilhelmsen, A Rosengren, G Lappas; MRFIT: L Kuller; NCS: R Selmer, A Tverdal, W Nystad; NHANES I,NHANES II, NHANES III: R Gillum, M Mussolino; NHS: E Rimm, S Hankinson, J Manson, J Pai; NPHS I: TW Meade, JA Cooper, B De Stavola, C Knottenbelt; NPHS II: JA Cooper, KA Bauer, RD Rosenberg; OSAKA: S Sato, A Kitamura, Y Naito, H Iso; OSLO: I Holme, R Selmer, A Tverdal, W Nystad; OYABE: H Nakagawa, K Miura; PARIS1: P Ducimetiere, X Jouven; PRHPP: C Crespo, M Garcia-Palmieri; PRIME: P Amouyel, D Arveiler, A Evans, J Ferrieres; PROCAM: H Schulte, G Assmann; PROSPER: J Shepherd, C Packard, N Sattar, I Ford; QUEBEC: B Cantin, B Lamarche, J-P Després, GR Dagenais; RANCHO: E Barrett-Connor, D Wingard; R Bettencourt; REYK: V Gudnason, T Aspelund, G Sigurdsson, B Thorsson; RIFLE: M Trevisan; ROTT: J Witteman, I Kardys, M Breteler, A Hofman; SHHEC: H Tunstall-Pedoe, R Tavendale, GDO Lowe, M Woodward; SPEEDWELL: Y Ben-Shlomo; STRONG: BV Howard, Y Zhang, L Best, J Umans; TARFS: A Onat; TPT: TW Meade; TROMSO: I Njolstad, E Mathiesen, ML Lochen, T Wilsgaard; USPHS: JM Gaziano, M Stampfer, P Ridker; VHMPP: H Ulmer, G Diem, H Concin; VITA: F Rodeghiero, A Tosetto; WHITEII: E Brunner, M Shipley; WHS: P Ridker, J Buring; WOSCOPS: J Shepherd, SM Cobbe, I Ford, M Robertson; XIAN: Y He; ZARAGOZA: AM Ibanez; ZUTE: EJM Feskens, D Kromhout.

    Authors/Coordinating Centre: R Collins, J Danesh (principal investigator), E Di Angelantonio, S Erqou, S Kaptoge, S Lewington, L Orfei, L Pennells, P Perry, K Ray, N Sarwar, M Scherman, A Thompson, SG Thompson, M Walker, S Watson, F Wensley, IR White, AM Wood.

    C Packard (lipids), MB Pepys (inflammatory markers), GDO Lowe (haemostatic and inflammatory markers), S Marcovina (lipoprotein[a]), M Boekholdt (apolipoproteins), S O’Rahilly and N Sattar (metabolic markers) contribute expertise to the ERFC. Z Jabbar translated documents. Gary Whitlock commented helpfully on the draft document. K Prasad provides administrative support.

    Funding: The ERFC Coordinating Centre is underpinned by a programme grant from the British Heart Foundation and supported by specific grants from the UK Medical Research Council (triglycerides) and the BUPA Foundation (C-reactive protein). A variety of sources have supported recruitment, follow-up and laboratory measurements in the 104 cohorts contributing to the ERFC. Investigators of several of these studies have contributed to a list naming some of these funding sources, which can be found at http://www.phpc.cam.ac.uk/MEU/ERFC.

    Appendix I

    List of acronyms for studies in the Emerging Risk Factors Collaboration*

    • AFTCAPS (Air Force/Texas Coronary Atherosclerosis Prevention Study)

    • ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

    • AMORIS (Apolipoprotein Related Mortality Risk Study)

    • ARIC (Atherosclerosis Risk in Communities Study)

    • BHS (Busselton Health Study)

    • BRHS (British Regional Heart Study)

    • BRUN (Bruneck Study)

    • BUPA (British Union Provident Association)

    • BWHHS (British Women’s Heart and Health Study)

    • CaPS (Caerphilly Prospective Study)

    • CASTEL (Cardiovascular Study in the Elderly)

    • CHARL (Charleston Heart Study)

    • CHS (Cardiovascular Health Study)

    • COPEN (Copenhagen City Heart Study)

    • CUORE (Progetto CUORE)

    • DUBBO (Dubbo Study of the Elderly)

    • EAS (Edinburgh Artery Study)

    • EPESEBOS (Established Populations for the Epidemiologic Study of the Elderly Studies, East Boston)

    • EPESEIOW (Established Populations for the Epidemiologic Study of the Elderly Studies, Iowa)

    • EPESENCA (Established Populations for the Epidemiologic Study of the Elderly Studies, North Carolina)

    • EPESENHA (Established Populations for the Epidemiologic Study of the Elderly Studies, New Haven)

    • EPICNOR (European Prospective Investigation of Cancer Norfolk Study)

    • FIA (First Myocardial Infarction in Northern Sweden)

    • FINE_IT (Finland, Italy and Netherlands Elderly Study - Italian Cohorts)

    • FINRISK92, 97 (Finrisk Cohort–1992, 1997)

    • FLETCHER (Fletcher Challenge Blood Study)

    • FRAMOFF (Framingham Offspring Cohort)

    • FRICVE (Fibrinogeno como Factor de Riesgo Coronario en Venezuela)

    • GLOSTRUP (Research Centre for Prevention and Health)

    • GOH (The Glucose Intolerance, Obesity and Hypertension Study)

    • GOTO33, GOTO43 (Goteborg Studies–1933, 1943)

    • GOTOW (Population Study of Women in Göteborg, Sweden)

    • GRIPS (Göttingen Risk Incidence and Prevalence Study)

    • HELSINAG (Helsinki Aging Study)

    • HONOL (Honolulu Heart Program)

    • HOORN (Hoorn Study)

    • HPFS (Health Professionals Follow-up Study)

    • IKNS (Ikawa, Kyowa, and Noichi Study)

    • ISRAEL (Israeli Ischaemic Heart Disease Study)

    • KARELIA (North Karelia Project)

    • KIHD (Kuopio Ischaemic Heart Disease Study)

    • LASA (Longitudinal Aging Study Amsterdam)

    • LEADER (Lower Extremity Arterial Disease Event Reduction Trial)

    • MALMO (Malmö Study)

    • MOGERAUG1, 2, 3 (MONICA/KORA Augsburg Surveys S1- S3)

    • MOSWEGOT (MONICA Göteborg Study)

    • MRFIT (Multiple Risk Factor Intervention Trial 1)

    • NCS (Norwegian Counties Study)

    • NHANES I, II, III (National Health and Nutrition Examination Survey I, II, III)

    • NHS (Nurses’ Health Study)

    • NPHSI, II (Northwick Park Heart Study I, II)

    • OSAKA (Osaka Study)

    • OSLO (Oslo Study)

    • OYABE (Oyabe study)

    • PARIS I (Paris Prospective Study I)

    • PRHHP (Puerto Rico Heart Health Program)

    • PRIME (Prospective Epidemiological Study of Myocardial Infarction)

    • PROSPER (Prospective Study of Pravastatin in the Elderly at Risk)

    • PROCAM (Prospective Cardiovascular Münster Study)

    • QUEBEC (Quebec Cardiovascular Study)

    • RANCHO (Rancho Bernardo Study)

    • REYK (Reykjavik Study)

    • RIFLE (Risk Factors and Life Expectancy Pooling Project)

    • ROTT (The Rotterdam Study)

    • SHHEC (Scottish Heart Health Extended Cohort)

    • SPEED (Speedwell Study)

    • STRONG (Strong Heart Study)

    • TARFS (Turkish Adult Risk Factor Study)

    • TPT (Thrombosis Prevention Trial)

    • TROMSO (Tromso Study)

    • USPHS (U.S. Physicians Health Study)

    • VHMPP (Vorarlberg Health Monitoring and Promotion Programme)

    • VITA (Vicenza Thrombophilia and Athrosclerosis Project)

    • WHITEII (Whitehall II Study)

    • WHS (Women’s Health Study)

    • WOSCOPS (West of Scotland Coronary Prevention Study)

    • XIAN (Xi’an Cohort Study)

    • ZARAGOZA (Zaragoza study)

    • ZUTE (Zutphen Elderly Study)

    * It is intended to use these acronyms in subsequent papers.

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    The Emerging Risk Factors Collaboration. The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases. Eur J Epidemiol 22, 839–869 (2007). https://doi.org/10.1007/s10654-007-9165-7

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