Predictive value of remnant lipoprotein for cardiovascular events in patients with coronary artery disease after achievement of LDL-cholesterol goals
| Autor: | Yosuke Watanabe, Ken-ichi Kawabata, Hideto Mishina, Yoshinobu Kitta, Kazuhiro Watanabe, Kiyotaka Kugiyama, Daisuke Fujioka, Takamitsu Nakamura, Yukio Saito, Jun-ei Obata, Mitsumasa Hirano |
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| Rok vydání: | 2011 |
| Předmět: |
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medicine.medical_specialty Apolipoprotein B Lipoproteins Cardiology Coronary Artery Disease Coronary artery disease chemistry.chemical_compound Predictive Value of Tests Risk Factors Internal medicine Humans Medicine In patient Triglycerides Aged Apolipoproteins B Proportional Hazards Models biology Remnant Lipoprotein business.industry Proportional hazards model Cholesterol Cholesterol HDL Cholesterol LDL Middle Aged medicine.disease chemistry Cardiovascular Diseases Predictive value of tests biology.protein Female lipids (amino acids peptides and proteins) Cardiology and Cardiovascular Medicine business Follow-Up Studies Lipoprotein |
| Zdroj: | Atherosclerosis. 218:163-167 |
| ISSN: | 0021-9150 |
| Popis: | Triglycerides-rich lipoproteins are related to residual cardiovascular risk in patients on lipid-lowering treatment who achieve low-density lipoprotein cholesterol (LDL-C) goals. This study examined the predictive value of remnant lipoprotein levels for cardiovascular events in patients with coronary artery disease (CAD) with LDL-C levels100mg/dL on lipid-lowering therapy.Serum levels of remnant lipoproteins (remnant-like lipoprotein particles cholesterol; RLP-C) were measured by an immunoseparation method in 560 patients with CAD who had LDL-C levels100mg/dL on lipid-lowering therapy, including statin (58%), fibrate (13%) or diet only (29%). All the patients were followed prospectively for a period of ≤ 36 months or until occurrence of one of the following events: cardiac death, non fatal myocardial infarction, unstable angina requiring coronary revascularization, or ischemic stroke.During a mean follow-up period of 33 months, 40 events occurred. Stepwise multivariate Cox proportional hazard analysis showed that RLP-C was a significant predictor of cardiovascular events after adjustment for known risk factors and lipid variables including triglycerides, non-high-density lipoprotein (HDL)-C, and total apolipoprotein B (HR 1.53, 95% CI 1.35-1.97, p0.01). The c-statistics showed that addition of RLP-C had a greater incremental effect on the predictive value of conventional risk factors than addition of non-HDL-C or total apolipoprotein B.RLP-C was superior to non-HDL-C for predicting cardiovascular events in CAD patients with LDL-C levels100mg/dL on lipid-lowering treatment. Remnant lipoprotein may therefore be an important target for residual risk reduction after LDL-C goals on lipid lowering therapy. |
| Databáze: | OpenAIRE |
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