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Sökning: WFRF:(HOLME P) > (2005-2009) > Congestive heart fa...

  • Holme, IngarUllevaal University Hospital (författare)

Congestive heart failure is associated with lipoprotein components in statin-treated patients with coronary heart disease Insights from the Incremental Decrease in End points Through Aggressive Lipid Lowering Trial (IDEAL)

  • Artikel/kapitelEngelska2009

Förlag, utgivningsår, omfång ...

  • Elsevier BV,2009
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:liu-20617
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-20617URI
  • https://doi.org/10.1016/j.atherosclerosis.2009.01.023DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Background: Very few, if any, studies have assessed the ability of apolipoproteins to predict new-onset of congestive heart failure (HF) in statin-treated patients with coronary heart disease (CHD). Aims: To employ the Incremental Decrease in End points Through Aggressive Lipid Lowering Trial (IDEAL) study database to assess the association of on-treatment lipoprotein components with prediction of HF events and to compare their predictive value with that of established risk factors such as hypertension and diabetes. Methods: We used Cox regression models to study the relationships between on-treatment levels of apolipoproteins A1 and B to subsequent HE Chi square information value from the log likelihood was used to compare the predictive value of lipoprotein components with established risk factors of HF. Findings: In the IDEAL study, on-treatment apolipoproteins proved to be associated with the occurrence of new-onset HE Variables related to low-density lipoprotein cholesterol (LDL-C) carried less predictive information than those related to high-density lipoprotein cholesterol (HDL-C), and apoA-1 was the single variable most strongly associated with HF. LDL-C was less predictive than both non-HDL-C (total cholesterol minus HDL-C) and apoB. The ratio of apoB to apoA-1 was most strongly related to HF after adjustment for potential confounders, among which diabetes had a stronger correlation with HF than did hypertension. ApoB/apoA-1 carried approximately 2.2 times more of the statistical information value than that of diabetes. Calculation of the net reclassification improvement index revealed that about 3.7% of the patients had to be reclassified into more correct categories of risk once apoB/apoA-1 was added to the adjustment factors. The reduction in risk by intensive lipid-lowering treatment as compared to usual-dose simvastatin was well predicted by the difference in apoB/apoA-1 on-treatment levels. Interpretation: The on-treatment ratio of apoB/apoA-1 was the strongest predictor of HF in CHD patients of both IDEAL treatment arms combined, mostly driven by the strong association with apoA-1, whereas LDL-C and non-HDL-C were less able to predict HF outcome. The predictive information value contained within apoB/apoA-1 was about 2.2 times more than that of diabetes. Between-treatment group differences in HF were to a significant extent explained by on-treatment differences in apoB/apoA-1, mostly through the changes in apoB. We argue therefore, on-treatment lipoprotein components contribute to the overall future risk of HF in statin-treated patients with CHD.

Ämnesord och genrebeteckningar

  • Congestive heart failure
  • Statin
  • Apolipoproteins
  • Lipoproteins
  • Risk prediction
  • MEDICINE
  • MEDICIN

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • E Strandberg, TimoUniversity of Oulu (författare)
  • Faergeman, OleArhus University Hospital (författare)
  • Kastelein, John J PUniversity of Amsterdam (författare)
  • Olsson, AndersÖstergötlands Läns Landsting,Linköpings universitet,Internmedicin,Hälsouniversitetet,Endokrin- och magtarmmedicinska kliniken US(Swepub:liu)andol21 (författare)
  • Tikkanen, Matti JUniversity of Helsinki (författare)
  • Lytken Larsen, MogensArhus University Hospital (författare)
  • Lindahl, ChristinaPfizer Sweden (författare)
  • Pedersen, Terje RUllevaal University Hospital (författare)
  • Ullevaal University HospitalUniversity of Oulu (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:ATHEROSCLEROSIS: Elsevier BV205:2, s. 522-5270021-9150

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