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  • Kastelein, John J. P.Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1100 DD Amsterdam, Netherlands (author)

Lipids, apolipoproteins, and their ratios in relation to cardiovascular events with statin treatment

  • Article/chapterEnglish2008

Publisher, publication year, extent ...

  • 2008
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-45885
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-45885URI
  • https://doi.org/10.1161/CIRCULATIONAHA.107.713438DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background - Low-density lipoprotein (LDL)cholesterol is the principal target of lipid-lowering therapy, but recent evidence has suggested more appropriate targets. We compared the relationships of on-treatment levels of LDL cholesterol, non-high-density lipoprotein (HDL) cholesterol, and apolipoprotein B, as well as ratios of total/HDL cholesterol, LDL/HDL cholesterol, and apolipoprotein B/A-I, with the occurrence of cardiovascular events in patients receiving statin therapy. Methods and Results - A post hoc analysis was performed that combined data from 2 prospective, randomized clinical trials in which 10 001 ("Treating to New Targets") and 8888 ("Incremental Decrease in End Points through Aggressive Lipid Lowering") patients with established coronary heart disease were assigned to usual-dose or high-dose statin treatment. In models with LDL cholesterol, non-HDL cholesterol and apolipoprotein B were positively associated with cardiovascular outcome, whereas a positive relationship with LDL cholesterol was lost. In a model that contained non-HDL cholesterol and apolipoprotein B, neither was significant owing to collinearity. Total/HDL cholesterol ratio and the apolipoprotein B/A-I ratio in particular were each more closely associated with outcome than any of the individual proatherogenic lipoprotein parameters. Conclusions - In patients receiving statin therapy, on-treatment levels of non-HDL cholesterol and apolipoprotein B were more closely associated with cardiovascular outcome than levels of LDL cholesterol. Inclusion of measurements of the antiatherogenic lipoprotein fraction further strengthened the relationships. These data support the use of non-HDL cholesterol or apolipoprotein B as novel treatment targets for statin therapy. Given the absence of interventions that have been proven to consistently reduce cardiovascular disease risk through raising plasma levels of HDL cholesterol or apolipoprotein A-I, it seems premature to consider the ratio variables as clinically useful.

Subject headings and genre

  • apolipoproteins
  • cardiovascular diseases
  • cholesterol
  • myocardial infarction
  • prevention
  • MEDICINE
  • MEDICIN

Added entries (persons, corporate bodies, meetings, titles ...)

  • van der Steeg, Wim A.Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1100 DD Amsterdam, Netherlands (author)
  • Holme, IngarUllevaal Univ Hosp, Ctr Prevent Med, Oslo, Norway (author)
  • Gaffney, MichaelPfizer Inc, New York, NY USA (author)
  • Cater, Nilo B.Pfizer Inc, New York, NY USA (author)
  • Barter, PhilipHeart Res Inst, Sydney, NSW, Australia (author)
  • Deedwania, PrakashVet Affairs Cent Calif Healthcare Syst, San Francisco, CA USA (author)
  • Olsson, AndersÖstergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Internmedicin,Endokrin- och magtarmmedicinska kliniken US(Swepub:liu)andol21 (author)
  • Boekholdt, S. MatthijsUniv Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1100 DD Amsterdam, Netherlands (author)
  • Demicco, David A.Pfizer Inc, New York, NY USA (author)
  • Szarek, MichaelPfizer Inc, New York, NY USA (author)
  • LaRosa, John C.SUNY Hlth Sci Ctr, Brooklyn, NY 11203 USA (author)
  • Pedersen, Terje R.Ullevaal Univ Hosp, Ctr Prevent Med, Oslo, Norway (author)
  • Grundy, SUniv Texas SW Med Ctr Dallas, Dallas, TX 75390 USA (author)
  • Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1100 DD Amsterdam, NetherlandsUllevaal Univ Hosp, Ctr Prevent Med, Oslo, Norway (creator_code:org_t)

Related titles

  • In:Circulation117:23, s. 3002-30090009-73221524-4539

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