Supplementary Table 7. Adjusted hazard ratios for incident CVD, CHD, stroke, and their subtypes according to serum ALP levels after excluding participants with CKD (eGFR ＜60 mL/min/1.73 m2) in men and women (n = 23,728) .
| Outcomes | Quartiles of ALP levels＊, U/L | p for trend§ | Natural log- transformed continuous | |||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | |||
| Men | ||||||
| CVD | ||||||
| No. of cases/person years | 641/17,598 | 744/18,371 | 863/19,300 | 794/17,106 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.11 (1.00-1.23) | 1.21 (1.10-1.35) | 1.24 (1.12-1.38) | ＜0.001 | 1.32 (1.16-1.50) |
| CHD | ||||||
| No. of cases/person years | 490/18,170 | 556/19,036 | 665/19,833 | 560/17,841 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.08 (0.95-1.22) | 1.24 (1.10-1.39) | 1.14 (1.01-1.29) | 0.01 | 1.18 (1.02-1.37) |
| ACS | ||||||
| No. of cases/person years | 172/16,572 | 259/17,519 | 305/18,088 | 234/16,141 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.41 (1.16-1.71) | 1.58 (1.31-1.91) | 1.32 (1.08-1.61) | 0.02 | 1.34 (1.06-1.68) |
| Stroke | ||||||
| No. of cases/person years | 151/19,208 | 188/20,175 | 198/21,465 | 234/18,896 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.18 (0.95-1.46) | 1.15 (0.93-1.42) | 1.51 (1.23-1.86) | ＜0.001 | 1.76 (1.36-2.29) |
| Ischemic stroke | ||||||
| No. of cases/person years | 128/19,099 | 150/20,002 | 159/21,272 | 196/18,730 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.12 (0.88-1.42) | 1.09 (0.86-1.38) | 1.49 (1.19-1.86) | ＜0.001 | 1.71 (1.28-2.28) |
| Hemorrhagic stroke | ||||||
| No. of cases/person years | 23/18,529 | 38/19,479 | 39/20,706 | 38/18,024 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.55 (0.92-2.60) | 1.49 (0.89-2.50) | 1.67 (0.99-2.83) | 0.10 | 2.10 (1.13-3.92) |
| Women | ||||||
| CVD | ||||||
| No. of cases/person years | 605/25,959 | 663/25,513 | 833/25,905 | 899/25,558 | ||
| HR (95% CI)† | 1.00 (Ref) | 0.96 (0.86-1.07) | 1.12 (1.00-1.24) | 1.12 (1.01-1.25) | 0.004 | 1.15 (1.02-1.30) |
| CHD | ||||||
| No. of cases/person years | 514/26,277 | 563/25,861 | 709/26,319 | 746/26,030 | ||
| HR (95% CI)† | 1.00 (Ref) | 0.96 (0.85-1.09) | 1.13 (1.00-1.26) | 1.11 (0.99-1.25) | 0.01 | 1.12 (0.98-1.28) |
| ACS | ||||||
| No. of cases/person years | 167/24,508 | 206/23,852 | 241/23,706 | 293/23,408 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.05 (0.85-1.29) | 1.15 (0.94-1.41) | 1.26 (1.04-1.53) | 0.008 | 1.22 (0.98-1.52) |
| Stroke | ||||||
| No. of cases/person years | 91/27,684 | 100/27,400 | 124/28,462 | 153/28,074 | ||
| HR (95% CI)† | 1.00 (Ref) | 0.96 (0.72-1.27) | 1.04 (0.79-1.37) | 1.16 (0.89-1.52) | 0.15 | 1.34 (0.99-1.83) |
| Ischemic stroke | ||||||
| No. of cases/person years | 73/27,601 | 74/27,276 | 98/28,314 | 118/27,909 | ||
| HR (95% CI)† | 1.00 (Ref) | 0.87 (0.63-1.20) | 1.01 (0.74-1.37) | 1.09 (0.81-1.47) | 0.31 | 1.34 (0.94-1.89) |
| Hemorrhagic stroke | ||||||
| No. of cases/person years | 18/27,333 | 26/27,025 | 26/27,995 | 35/27,485 | ||
| HR (95% CI)† | 1.00 (Ref) | 1.32 (0.72-2.41) | 1.18 (0.64-2.18) | 1.46 (0.82-2.62) | 0.25 | 1.37 (0.71-2.63) |
＊The quartiles of ALP levels in men were Q1 (＜69 U/L), Q2 (69-84 U/L), Q3 (84-100 U/L), and Q4 (＞100 U/L), while the quartiles of ALP levels in women were Q1 (＜71 U/L), Q2 (71-87 U/L), Q3 (87-105 U/L), and Q4 (＞105 U/L), respectively.
†Models were adjusted for age, BMI, smoking status, drinking status, physical activity, hypertension, hyperlipidemia, diabetes, aspirin usage, anticoagulants usage, menopausal status (women only), eGFR, family history of CVD, WBC, and admission batch.
§p for trend was obtained by assigning the median value to each group and used this as a continuous variable in Cox regression models.
Abbreviations: ACS, acute coronary syndrome; ALP, alkaline phosphatase; BMI, body mass index; CHD, coronary heart disease; CI, coefficient interval; CKD, chronic kidney disease; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; HR, hazard ratio; SD, standard deviation; WBC, white blood cell.