Association of high-density lipoprotein particle concentration with cardiovascular risk following acute coronary syndrome: A case-cohort analysis of the dal-Outcomes trial
| Autor: | Donald M. Black, Taufiq Salahuddin, Jean-Claude Tardif, Lawrence A. Leiter, David Kallend, Philip J. Barter, Eran Leitersdorf, Stephen J. Nicholls, Christie M. Ballantyne, Anders G. Olsson, Prediman K. Shah, Gregory G. Schwartz, John Kittelson |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome Magnetic Resonance Spectroscopy Dalcetrapib Myocardial Infarction Coronary Disease 030204 cardiovascular system & hematology Placebo 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Humans Angina Unstable Sulfhydryl Compounds cardiovascular diseases 030212 general & internal medicine Acute Coronary Syndrome Aged Randomized Controlled Trials as Topic business.industry Cholesterol Anticholesteremic Agents Cholesterol HDL Hazard ratio Case-control study Esters Middle Aged Prognosis High-density lipoprotein particle medicine.disease Amides Hospitalization Stroke chemistry Case-Control Studies Cardiology Female Lipoproteins HDL Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | American Heart Journal. 221:60-66 |
| ISSN: | 0002-8703 |
| Popis: | Background High-density lipoprotein cholesterol (HDL-C) concentration is inversely related to risk of major adverse cardiovascular events (MACE) in epidemiologic studies but is a poorer predictor of MACE in patients with established coronary heart disease. HDL particle concentration (HDLP) has been proposed as a better predictor of risk. We investigated whether HDLP is associated with risk of MACE after acute coronary syndrome (ACS). Methods The dal-Outcomes trial compared the CETP inhibitor dalcetrapib with placebo in patients with recent ACS. In a nested case-cohort analysis, total, large, medium, and small HDLPs were measured by nuclear magnetic resonance spectroscopy at baseline (4-12 weeks after ACS) in 476 cases with MACE and 902 controls. Hazard ratios (HRs; case-control) for 1-SD increment of HDLP or HDL-C at baseline were calculated with and without adjustment for demographic, clinical, laboratory, and treatment variables. Similarly, HRs for MACE were calculated for changes in HDLP or HDL-C from baseline to month 3 of assigned treatment. Results Over median follow-up of 28 months, the risk of MACE was not associated with baseline HDLP (adjusted HR = 0.98, 95% CI = 0.84-1.15, P = .81), any HDLP subclass, or HDL-C. Dalcetrapib increased HDL-C and total, medium, and large HDLP and decreased small HDLP but had no effect on MACE compared with placebo. There were no association of risk of MACE with change in HDLP or HDL-C and no interaction with assigned study treatment. Conclusions Neither baseline HDLP nor the change in HDLP on treatment with dalcetrapib or placebo was associated with risk of MACE after ACS. |
| Databáze: | OpenAIRE |
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