The Emerging Risk Factors Collaboration (ERFC) conducted a comprehensive analysis to assess the associations of major lipids and apolipoproteins with the risk of vascular disease. The study included data from 302,430 participants from 68 long-term prospective studies, primarily in Europe and North America. During 2.79 million person-years of follow-up, there were 8,857 nonfatal myocardial infarctions, 3,928 coronary heart disease (CHD) deaths, 2,534 ischemic strokes, 513 hemorrhagic strokes, and 2,536 unclassified strokes. Key findings include: - Hazard ratios (HRs) for CHD were adjusted for several conventional factors, including triglyceride, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, apolipoprotein A1 (apo A1), apolipoprotein B (apo B), and directly measured low-density lipoprotein cholesterol (LDL-C). - HRs for CHD were nearly identical for non-HDL-C and HDL-C compared to apo B and apo A1, suggesting that practical considerations, such as cost and assay standardization, should guide the choice of lipid measures in vascular risk assessment. - HRs for CHD were at least as strong in participants who did not fast as in those who fasted. - HRs for CHD were similar with non-HDL-C as with directly measured LDL-C. - Triglyceride concentration was not independently associated with CHD risk after controlling for HDL-C, non-HDL-C, and other standard risk factors, including null findings in women and under nonfasting conditions. - HDL-C and non-HDL-C were strongly associated with CHD risk in an approximately log-linear manner, but they were largely independent from each other on a multiplicative scale. - The study concluded that lipid assessment in vascular disease can be simplified by measuring either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride.The Emerging Risk Factors Collaboration (ERFC) conducted a comprehensive analysis to assess the associations of major lipids and apolipoproteins with the risk of vascular disease. The study included data from 302,430 participants from 68 long-term prospective studies, primarily in Europe and North America. During 2.79 million person-years of follow-up, there were 8,857 nonfatal myocardial infarctions, 3,928 coronary heart disease (CHD) deaths, 2,534 ischemic strokes, 513 hemorrhagic strokes, and 2,536 unclassified strokes. Key findings include: - Hazard ratios (HRs) for CHD were adjusted for several conventional factors, including triglyceride, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, apolipoprotein A1 (apo A1), apolipoprotein B (apo B), and directly measured low-density lipoprotein cholesterol (LDL-C). - HRs for CHD were nearly identical for non-HDL-C and HDL-C compared to apo B and apo A1, suggesting that practical considerations, such as cost and assay standardization, should guide the choice of lipid measures in vascular risk assessment. - HRs for CHD were at least as strong in participants who did not fast as in those who fasted. - HRs for CHD were similar with non-HDL-C as with directly measured LDL-C. - Triglyceride concentration was not independently associated with CHD risk after controlling for HDL-C, non-HDL-C, and other standard risk factors, including null findings in women and under nonfasting conditions. - HDL-C and non-HDL-C were strongly associated with CHD risk in an approximately log-linear manner, but they were largely independent from each other on a multiplicative scale. - The study concluded that lipid assessment in vascular disease can be simplified by measuring either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride.