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Role of non-high-density lipoprotein cholesterol in predicting cerebrovascular events in patients following myocardial infarction.
Am J Cardiol. 2012 Jun 15; 109(12):1694-9.AJ

Abstract

Although there appears to be a role for statins in reducing cerebrovascular events, the exact role of different lipid fractions in the etiopathogenesis of cerebrovascular disease (CVD) is not well understood. A secondary analysis of data collected for the placebo arm (n = 2,078) of the Cholesterol and Recurrent Events (CARE) trial was performed. The CARE trial was a placebo-controlled trial aimed at testing the effect of pravastatin on patients after myocardial infarction. Patients with histories of CVD were excluded from the study. A Cox proportional-hazards model was used to evaluate the association between plausible risk factors (including lipid fractions) and risk for first incident CVD in patients after myocardial infarction. At the end of 5 years, 123 patients (6%) had incident CVD after myocardial infarction (76 with stroke and 47 with transient ischemic attack). Baseline non-high-density lipoprotein (HDL) cholesterol level emerged as the only significant lipid risk factor that predicted CVD; low-density lipoprotein cholesterol and HDL cholesterol were not significant. The adjusted hazard ratios (adjusted for age, gender, hypertension, diabetes mellitus, and smoking) for CVD were 1.28 (95% confidence interval [CI] 1.06 to 1.53) for non-HDL cholesterol, 1.14 (95% CI 0.96 to 1.37) for low-density lipoprotein cholesterol, and 0.90 (95% CI 0.75 to 1.09) for HDL cholesterol (per unit SD change of lipid fractions). This relation held true regardless of the level of triglycerides. After adjustment for age and gender, the hazard ratio for the highest natural quartile of non-HDL was 1.76 (95% CI 1.05 to 2.54), compared to 1.36 (95% CI 0.89 to 1.90) for low-density lipoprotein cholesterol. In conclusion, non-HDL cholesterol is the strongest predictor among the lipid risk factors of incident CVD in patients with established coronary heart disease.

Authors+Show Affiliations

Department of Cardiology, Wayne State University, Detroit, Michigan, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22465317

Citation

Mahajan, Nitin, et al. "Role of Non-high-density Lipoprotein Cholesterol in Predicting Cerebrovascular Events in Patients Following Myocardial Infarction." The American Journal of Cardiology, vol. 109, no. 12, 2012, pp. 1694-9.
Mahajan N, Ference BA, Arora N, et al. Role of non-high-density lipoprotein cholesterol in predicting cerebrovascular events in patients following myocardial infarction. Am J Cardiol. 2012;109(12):1694-9.
Mahajan, N., Ference, B. A., Arora, N., Madhavan, R., Bhattacharya, P., Sudhakar, R., Sagar, A., Wang, Y., Sacks, F., & Afonso, L. (2012). Role of non-high-density lipoprotein cholesterol in predicting cerebrovascular events in patients following myocardial infarction. The American Journal of Cardiology, 109(12), 1694-9. https://doi.org/10.1016/j.amjcard.2012.02.010
Mahajan N, et al. Role of Non-high-density Lipoprotein Cholesterol in Predicting Cerebrovascular Events in Patients Following Myocardial Infarction. Am J Cardiol. 2012 Jun 15;109(12):1694-9. PubMed PMID: 22465317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of non-high-density lipoprotein cholesterol in predicting cerebrovascular events in patients following myocardial infarction. AU - Mahajan,Nitin, AU - Ference,Brian A, AU - Arora,Natasha, AU - Madhavan,Ramesh, AU - Bhattacharya,Pratik, AU - Sudhakar,Rajeev, AU - Sagar,Amit, AU - Wang,Yun, AU - Sacks,Frank, AU - Afonso,Luis, Y1 - 2012/03/31/ PY - 2011/12/21/received PY - 2012/02/07/revised PY - 2012/02/07/accepted PY - 2012/4/3/entrez PY - 2012/4/3/pubmed PY - 2012/10/19/medline SP - 1694 EP - 9 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 109 IS - 12 N2 - Although there appears to be a role for statins in reducing cerebrovascular events, the exact role of different lipid fractions in the etiopathogenesis of cerebrovascular disease (CVD) is not well understood. A secondary analysis of data collected for the placebo arm (n = 2,078) of the Cholesterol and Recurrent Events (CARE) trial was performed. The CARE trial was a placebo-controlled trial aimed at testing the effect of pravastatin on patients after myocardial infarction. Patients with histories of CVD were excluded from the study. A Cox proportional-hazards model was used to evaluate the association between plausible risk factors (including lipid fractions) and risk for first incident CVD in patients after myocardial infarction. At the end of 5 years, 123 patients (6%) had incident CVD after myocardial infarction (76 with stroke and 47 with transient ischemic attack). Baseline non-high-density lipoprotein (HDL) cholesterol level emerged as the only significant lipid risk factor that predicted CVD; low-density lipoprotein cholesterol and HDL cholesterol were not significant. The adjusted hazard ratios (adjusted for age, gender, hypertension, diabetes mellitus, and smoking) for CVD were 1.28 (95% confidence interval [CI] 1.06 to 1.53) for non-HDL cholesterol, 1.14 (95% CI 0.96 to 1.37) for low-density lipoprotein cholesterol, and 0.90 (95% CI 0.75 to 1.09) for HDL cholesterol (per unit SD change of lipid fractions). This relation held true regardless of the level of triglycerides. After adjustment for age and gender, the hazard ratio for the highest natural quartile of non-HDL was 1.76 (95% CI 1.05 to 2.54), compared to 1.36 (95% CI 0.89 to 1.90) for low-density lipoprotein cholesterol. In conclusion, non-HDL cholesterol is the strongest predictor among the lipid risk factors of incident CVD in patients with established coronary heart disease. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/22465317/Role_of_non_high_density_lipoprotein_cholesterol_in_predicting_cerebrovascular_events_in_patients_following_myocardial_infarction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(12)00684-4 DB - PRIME DP - Unbound Medicine ER -