Triglyceride–Rich Lipoproteins, Apolipoproteins, and Atherosclerotic Cardiovascular Events Among Patients with Diabetes Mellitus and End–Stage Renal Disease on Hemodialysis

Autor: Cristoph Wanner, Ian H. de Boer, Julio A. Lamprea–Montealegre, Günther Silbernagel, Winfried März, Hubert Scharnagl, Ronit Katz, Christiane Drechsler
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Atorvastatin
Cholesterol
VLDL
Population
Myocardial Infarction
030232 urology & nephrology
Type 2 diabetes
030204 cardiovascular system & hematology
End stage renal disease
03 medical and health sciences
0302 clinical medicine
Renal Dialysis
Diabetes mellitus
Internal medicine
Myocardial Revascularization
medicine
Humans
Myocardial infarction
education
Triglycerides
Aged
Apolipoproteins B
Ischemic Stroke
Proportional Hazards Models
Apolipoprotein C-III
education.field_of_study
business.industry
Hypertriglyceridemia
Middle Aged
Atherosclerosis
medicine.disease
Diabetes Mellitus
Type 2
Cardiology
Kidney Failure
Chronic
Female
lipids (amino acids
peptides
and proteins)
Hemodialysis
Cardiology and Cardiovascular Medicine
business
medicine.drug
Zdroj: The American Journal of Cardiology. 152:63-68
ISSN: 0002-9149
DOI: 10.1016/j.amjcard.2021.04.023
Popis: Hypertriglyceridemia may be implicated in the high atherosclerotic cardiovascular disease (ASCVD) risk experienced by patients with end-stage renal disease (ESRD). In this post-hoc analysis of the "Die Deutsche Diabetes Dialyse Studie (4D)" clinical trial, we examined incident ASCVD events, defined as myocardial infarction, ischemic stroke, or a coronary revascularization procedure, among 1255 participants with type 2 diabetes and ESRD treated with hemodialysis. Cox-regression methods were used to evaluate the association of triglycerides, very-low density lipoprotein cholesterol (VLDL-C), and apolipoproteins B (Apo B) and C-III (Apo C-III) with ASCVD. During a median follow-up time of 2.3 years, 340 (27%) participants experienced an ASCVD event. Higher concentrations of triglycerides were not associated with ASCVD risk: Hazard ratio (HR) 0.95; 95% CI (0.83, 1.10) per doubling concentration. Similarly, VLDL-C HR 1.01; 95% CI (0.90, 1.13); Apo B HR 1.04; 95% CI (0.93, 1.16); and Apo C-III HR 0.97; 95% CI (0.86, 1.09) (per one standard deviation higher concentrations), were not associated with ASCVD events. These associations did not differ by allocation to treatment to atorvastatin or by concentrations of markers of inflammation or malnutrition. In conclusion, we found no evidence that triglycerides, triglyceride-rich lipoproteins, or apolipoproteins B or C-III were associated with risk of ASCVD events among patients with type 2 diabetes and ESRD on hemodialysis. These results suggest that lowering triglycerides may not decrease atherosclerotic cardiovascular risk in this population.
Databáze: OpenAIRE
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