P619Incident premature coronary heart disease in women: an analysis of 53 biomarkers from the Women's Health Study

Background: Premature coronary heart disease (CHD) is associated with high morbidity and mortality. The underlying predictors of premature CHD, particularly for women, are incompletely characterised. Purpose: To compare biomarker profiles predictive of incident premature (<65yr) versus conventional (≥65yr) CHD in apparently healthy women in the prospective Women's Health Study. Methods: Two sub-cohorts were defined based on age at enrollment: <65years old (premature; n=25042) and ≥65years old (conventional; n=2982). Self-reported cardiovascular risk factors, baseline levels of 53 biomarkers related to lipids, lipoprotein particle concentration and size, inflammation, and metabolism were analysed. Women were followed for incident CHD and analysed with Cox regression models adjusted for standard risk factors. Results: CHD incidence was 2% (n=435/25042) and 12% (n=343/2982) in premature and conventional cohorts, respectively. While premature and conventional CHD shared risk factors including LDL-C, HDL-C and hsCRP, the strength of associations with selected biomarkers differed. Lipoprotein(a), triglyceride-rich lipoprotein (TRL) particles, HDL size, and inflammatory biomarkers such as protein glycan side chains (GlycA) and fibrinogen showed stronger associations with premature CHD (Table). Biomarkers such as citrate showed no association with either cohort (not shown).