Low Levels of High-Density Lipoprotein Cholesterol and Increased Risk of Cardiovascular Events in Stable Ischemic Heart Disease Patients
| Autor: | Pamela M. Hartigan, William S. Weintraub, G.B. John Mancini, Subroto Acharjee, Steven P. Sedlis, William E. Boden, John A. Spertus, David J. Maron, Koon K. Teo, Bernard R. Chaitman, William J. Kostuk, Marcin Dada |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population 030204 cardiovascular system & hematology Revascularization 03 medical and health sciences 0302 clinical medicine Ezetimibe Internal medicine Post-hoc analysis medicine 030212 general & internal medicine Myocardial infarction education education.field_of_study business.industry Percutaneous coronary intervention medicine.disease 3. Good health Surgery Residual risk Quartile Cardiology lipids (amino acids peptides and proteins) Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of the American College of Cardiology. 62:1826-1833 |
| ISSN: | 0735-1097 |
| Popis: | Objectives This study sought to assess the independent effect of high-density lipoprotein-cholesterol (HDL-C) level on cardiovascular risk in patients with stable ischemic heart disease (SIHD) who were receiving optimal medical therapy (OMT). Background Although low HDL-C level is a powerful and independent predictor of cardiovascular risk, recent data suggest that this may not apply when low-density lipoprotein-cholesterol (LDL-C) is reduced to optimal levels using intensive statin therapy. Methods We performed a post-hoc analysis in 2,193 men and women with SIHD from the COURAGE trial. The primary outcome measure was the composite of death from any cause or nonfatal myocardial infarction (MI). The independent association between HDL-C levels measured after 6 months on OMT and the rate of cardiovascular events after 4 years was assessed. Similar analyses were performed separately in subjects with LDL-C levels below 70 mg/dl (1.8 mmol/l). Results In the overall population, the rate of death/MI was 33% lower in the highest HDL-C quartile as compared with the lowest quartile, with quartile of HDL-C being a significant, independent predictor of death/MI (p = 0.05), but with no interaction for LDL-C category (p = 0.40). Among subjects with LDL-C levels Conclusions In this post-hoc analysis, patients with SIHD continued to experience incremental cardiovascular risk associated with low HDL-C levels despite OMT during long-term follow-up. This relationship persisted and appeared more prominent even when LDL-C was reduced to optimal levels with intensive dyslipidemic therapy. (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation; NCT00007657 ) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|