Relationship of Oxidized Phospholipids on Apolipoprotein B-100 to Cardiovascular Outcomes in Patients Treated With Intensive Versus Moderate Atorvastatin Therapy
| Autor: | Young Sup Byun, Joseph L. Witztum, Sotirios Tsimikas, Xiaohong Yang, Jun-Hee Lee, Benoit J. Arsenault, Tnt Trial Investigators, David A. DeMicco, Rachel Laskey, Weihang Bao |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Randomization Atorvastatin Coronary Disease inflammatory 030204 cardiovascular system & hematology oxidation-specific epitope Article 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Humans Medicine Pyrroles cardiovascular diseases Myocardial infarction coronary heart disease Phospholipids Aged 030304 developmental biology 2. Zero hunger 0303 health sciences business.industry Hazard ratio Middle Aged medicine.disease Confidence interval 3. Good health Endocrinology Cardiovascular Diseases Heptanoic Acids Apolipoprotein B-100 Cohort Cardiology biomarker Female lipids (amino acids peptides and proteins) atherosclerosis Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business Oxidation-Reduction Body mass index Biomarkers Mace medicine.drug |
| Zdroj: | Journal of the American College of Cardiology. 65:1286-1295 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2015.01.050 |
| Popis: | Background Oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) is a biomarker of increased risk for major adverse cardiovascular events (MACE) in community cohorts, but its role in patients with stable coronary heart disease (CHD) is unknown. Objectives This study sought to examine the relationship between these oxidative biomarkers and cardiovascular outcomes in patients with established CHD. Methods In a random sample from the TNT (Treating to New Targets) trial, OxPL-apoB levels were measured in 1,503 patients at randomization (after an 8-week run-in period taking atorvastatin 10 mg) and 1 year after being randomized to atorvastatin 10 or 80 mg. We examined the association between baseline levels of OxPL-apoB and MACE, defined as death from CHD, nonfatal myocardial infarction, resuscitation after cardiac arrest, and fatal/nonfatal stroke, as well as the effect of statin therapy on OxPL-apoB levels and MACE. Results Patients with events (n = 156) had higher randomization levels of OxPL-apoB than those without events (p = 0.025). For the overall cohort, randomization levels of OxPL-apoB predicted subsequent MACE (hazard ratio [HR]: 1.21; 95% confidence interval: 1.04 to 1.41; p = 0.018) per doubling and tertile 3 versus tertile 1 (hazard ratio: 1.69; 95% confidence interval [CI]: 1.14 to 2.49; p = 0.01) after multivariate adjustment for age, sex, body mass index, among others, and treatment assignment. In the atorvastatin 10-mg group, tertile 3 was associated with a higher risk of MACE compared to the first tertile (HR: 2.08; 95% CI: 1.20 to 3.61; p = 0.01) but this was not significant in the atorvastatin 80-mg group (HR: 1.40; 95% CI: 0.80 to 2.46; p = 0.24). Conclusions Elevated OxPL-apoB levels predict secondary MACE in patients with stable CHD, a risk that is mitigated by atorvastatin 80 mg. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691 ) |
| Databáze: | OpenAIRE |
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