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High-density lipopr...
High-density lipoprotein, but not low-density lipoprotein cholesterol levels influence short-term prognosis after acute coronary syndrome : Results from the MIRACL trial
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- Olsson, Anders, 1940- (author)
- Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Internmedicin,Endokrin- och magtarmmedicinska kliniken US
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Schwartz, G (author)
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Szarek, M (author)
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Sasiela, W (author)
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Ezekowitz, M (author)
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Ganz, P (author)
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Oliver, M (author)
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Waters, D (author)
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Zeiher, A (author)
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(creator_code:org_t)
- 2005-03-11
- 2005
- English.
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In: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 26:9, s. 890-896
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Aims: Patients with acute coronary syndrome (ACS) in the Myocardial lschaemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study had diminished cardiovascular events after 16 weeks of treatment of atorvastatin 80 mg daily. We determined whether plasma lipoproteins at baseline and then at 6 weeks after randomization predicted clinical outcome. Methods and results: Cox proportional hazards models were constructed to determine relations between lipoproteins and clinical endpoint events. Baseline LDL cholesterol (LDL-C) did not predict outcome. In contrast, baseline HDL-C predicted outcome with a hazard ratio of 0.986 per mg/dL increment in HDL-C, P < 0.001, indicating 1.4% reduction in risk for each 1 mg/dL increase in HDL-C. Atorvastatin treatment profoundly lowered LDL-C, but had minimal effect on HDL-C. Neither Week 6 LDL-C nor absolute change of LDL-C from baseline by Week 6 had any significant impact on clinical endpoints occurring between Week 6 and Week 16 after randomization. Conclusion Plasma HDL-C, but not LDL-C, measured in the initial stage of ACS predicts the risk of recurrent cardiovascular events over the ensuing 16 weeks. LDL-C reduction does not account for the clinical risk reduction with atorvastatin treatment after ACS. This finding may suggest that the clinical benefit of atorvastatin after ACS is mediated by qualitative changes in the LDL particle and/or by non-lipid (pleiotropic) effects of the drug.
Keyword
- acute coronary syndrome
- intervention study
- lipoprotein
- statin
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Olsson, Anders, ...
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Schwartz, G
-
Szarek, M
-
Sasiela, W
-
Ezekowitz, M
-
Ganz, P
-
show more...
-
Oliver, M
-
Waters, D
-
Zeiher, A
-
show less...
- Articles in the publication
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European Heart J ...
- By the university
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Linköping University