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Statin therapy alters the relationship between apolipoprotein B and low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol targets in high-risk patients: the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin) trial.
J Am Coll Cardiol. 2008 Aug 19; 52(8):626-32.JACC

Abstract

OBJECTIVES

The purpose of this analysis was to compare concentrations of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C), and apolipoprotein B (apoB) before and during statin therapy.

BACKGROUND

Reducing LDL-C to a pre-determined goal may still leave an excess of atherogenic lipoproteins, as reflected in apoB levels.

METHODS

The MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY II) trial examined the effects of statin treatment in patients with high coronary heart disease (CHD) risk, LDL-C > or =130 and <250 mg/dl, and triglycerides <400 mg/dl. Therapy consisted of rosuvastatin (10 or 20 mg), atorvastatin (10 or 20 mg), or simvastatin (20 or 40 mg). The apoB and LDL-C or non-HDL-C at baseline and after 16 weeks of therapy were compared using linear regression.

RESULTS

In untreated patients, the apoB target of <90 mg/dl was roughly equivalent to an LDL-C level <100 mg/dl and a non-HDL-C level <130 mg/dl, which is consistent with existing apoB and lipoprotein guidelines. However, during statin therapy, to reach an apoB target of <90 mg/dl it was necessary to reduce non-HDL-C to <100 mg/dl or to reduce LDL-C to <70 mg/dl (in high-triglyceride patients) or <80 mg/dl (in lower-triglyceride patients). The tight correlation seen for non-HDL-C with apoB while on statin therapy (R(2) = 0.92) implies that non-HDL-C may be an acceptable surrogate for direct apoB measurement.

CONCLUSIONS

These data are consistent with the more aggressive cholesterol goals suggested for CHD patients, because achieving such targets also reduced apoB to the recommended level. (Mercury II-Compare the Efficacy and Safety of Lipid Lowering Agents Atorvastatin and Simvastatin With Rosuvastatin in High Risk Subjects With Type IIa and IIb Hypercholesterolemia; NCT00654407).

Authors+Show Affiliations

Baylor College of Medicine and the Methodist DeBakey Heart and Vascular Center, Houston, Texas 77030, USA. cmb@bcm.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18702965

Citation

Ballantyne, Christie M., et al. "Statin Therapy Alters the Relationship Between Apolipoprotein B and Low-density Lipoprotein Cholesterol and Non-high-density Lipoprotein Cholesterol Targets in High-risk Patients: the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin) Trial." Journal of the American College of Cardiology, vol. 52, no. 8, 2008, pp. 626-32.
Ballantyne CM, Raichlen JS, Cain VA. Statin therapy alters the relationship between apolipoprotein B and low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol targets in high-risk patients: the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin) trial. J Am Coll Cardiol. 2008;52(8):626-32.
Ballantyne, C. M., Raichlen, J. S., & Cain, V. A. (2008). Statin therapy alters the relationship between apolipoprotein B and low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol targets in high-risk patients: the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin) trial. Journal of the American College of Cardiology, 52(8), 626-32. https://doi.org/10.1016/j.jacc.2008.04.052
Ballantyne CM, Raichlen JS, Cain VA. Statin Therapy Alters the Relationship Between Apolipoprotein B and Low-density Lipoprotein Cholesterol and Non-high-density Lipoprotein Cholesterol Targets in High-risk Patients: the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin) Trial. J Am Coll Cardiol. 2008 Aug 19;52(8):626-32. PubMed PMID: 18702965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin therapy alters the relationship between apolipoprotein B and low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol targets in high-risk patients: the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin) trial. AU - Ballantyne,Christie M, AU - Raichlen,Joel S, AU - Cain,Valerie A, PY - 2007/12/20/received PY - 2008/04/07/revised PY - 2008/04/29/accepted PY - 2008/8/16/pubmed PY - 2008/9/17/medline PY - 2008/8/16/entrez SP - 626 EP - 32 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 52 IS - 8 N2 - OBJECTIVES: The purpose of this analysis was to compare concentrations of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C), and apolipoprotein B (apoB) before and during statin therapy. BACKGROUND: Reducing LDL-C to a pre-determined goal may still leave an excess of atherogenic lipoproteins, as reflected in apoB levels. METHODS: The MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY II) trial examined the effects of statin treatment in patients with high coronary heart disease (CHD) risk, LDL-C > or =130 and <250 mg/dl, and triglycerides <400 mg/dl. Therapy consisted of rosuvastatin (10 or 20 mg), atorvastatin (10 or 20 mg), or simvastatin (20 or 40 mg). The apoB and LDL-C or non-HDL-C at baseline and after 16 weeks of therapy were compared using linear regression. RESULTS: In untreated patients, the apoB target of <90 mg/dl was roughly equivalent to an LDL-C level <100 mg/dl and a non-HDL-C level <130 mg/dl, which is consistent with existing apoB and lipoprotein guidelines. However, during statin therapy, to reach an apoB target of <90 mg/dl it was necessary to reduce non-HDL-C to <100 mg/dl or to reduce LDL-C to <70 mg/dl (in high-triglyceride patients) or <80 mg/dl (in lower-triglyceride patients). The tight correlation seen for non-HDL-C with apoB while on statin therapy (R(2) = 0.92) implies that non-HDL-C may be an acceptable surrogate for direct apoB measurement. CONCLUSIONS: These data are consistent with the more aggressive cholesterol goals suggested for CHD patients, because achieving such targets also reduced apoB to the recommended level. (Mercury II-Compare the Efficacy and Safety of Lipid Lowering Agents Atorvastatin and Simvastatin With Rosuvastatin in High Risk Subjects With Type IIa and IIb Hypercholesterolemia; NCT00654407). SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/18702965/Statin_therapy_alters_the_relationship_between_apolipoprotein_B_and_low_density_lipoprotein_cholesterol_and_non_high_density_lipoprotein_cholesterol_targets_in_high_risk_patients:_the_MERCURY_II__Measuring_Effective_Reductions_in_Cholesterol_Using_Rosuvastatin__trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(08)01930-X DB - PRIME DP - Unbound Medicine ER -