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

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004591naa a2200433 4500
001oai:DiVA.org:liu-20617
003SwePub
008090915s2009 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-206172 URI
0247 a https://doi.org/10.1016/j.atherosclerosis.2009.01.0232 DOI
040 a (SwePub)liu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Holme, Ingaru Ullevaal University Hospital4 aut
2451 0a 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)
264 1b Elsevier BV,c 2009
338 a print2 rdacarrier
520 a 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.
653 a Congestive heart failure
653 a Statin
653 a Apolipoproteins
653 a Lipoproteins
653 a Risk prediction
653 a MEDICINE
653 a MEDICIN
7001 a E Strandberg, Timou University of Oulu4 aut
7001 a Faergeman, Oleu Arhus University Hospital4 aut
7001 a Kastelein, John J Pu University of Amsterdam4 aut
7001 a Olsson, Andersu Östergötlands Läns Landsting,Linköpings universitet,Internmedicin,Hälsouniversitetet,Endokrin- och magtarmmedicinska kliniken US4 aut0 (Swepub:liu)andol21
7001 a Tikkanen, Matti Ju University of Helsinki4 aut
7001 a Lytken Larsen, Mogensu Arhus University Hospital4 aut
7001 a Lindahl, Christinau Pfizer Sweden4 aut
7001 a Pedersen, Terje Ru Ullevaal University Hospital4 aut
7102 a Ullevaal University Hospitalb University of Oulu4 org
7730 t ATHEROSCLEROSISd : Elsevier BVg 205:2, s. 522-527q 205:2<522-527x 0021-9150
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-20617
8564 8u https://doi.org/10.1016/j.atherosclerosis.2009.01.023

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