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Alteration of relation of atherogenic lipoprotein cholesterol to apolipoprotein B by intensive statin therapy in patients with acute coronary syndrome (from the Limiting UNdertreatment of lipids in ACS With Rosuvastatin [LUNAR] Trial).
Am J Cardiol. 2013 Feb 15; 111(4):506-9.AJ

Abstract

The low-density lipoprotein (LDL) cholesterol goal of <70 mg/dl, recommended for patients with acute coronary syndrome, typically requires intensive therapy with high-dose statins. The secondary goals of non-high-density lipoprotein (non-HDL) cholesterol <100 mg/dl and apolipoprotein B (ApoB) <80 mg/dl have been recommended to reduce excess cardiovascular risk not captured by LDL cholesterol. The present post hoc analysis from the Limiting UNdertreatment of lipids in Acute coronary syndrome with Rosuvastatin (LUNAR) study examined the relation of ApoB with LDL cholesterol and non-HDL cholesterol at baseline and during treatment with intensive statin therapy. The LUNAR participants had acute coronary syndrome and received rosuvastatin 40 mg/day or 20 mg/day or atorvastatin 80 mg/day for 12 weeks. Linear regression analyses were used to compare ApoB, direct LDL cholesterol, and non-HDL cholesterol at baseline and during therapy. Of the 682 patients included in the analysis, 220 had triglycerides ≥200 mg/dl. Linear regression analysis showed that correlation of ApoB and non-HDL cholesterol was stronger than that of ApoB and LDL cholesterol and stronger with statin therapy than at baseline (R(2) = 0.93 for ApoB vs non-HDL cholesterol with statins). The target of ApoB of 80 mg/dl correlated with LDL cholesterol of 90 mg/dl and non-HDL cholesterol of 110 mg/dl at baseline and with LDL cholesterol of 74 mg/dl and non-HDL cholesterol of 92 mg/dl with statin therapy. For high-triglyceride patients, the corresponding on-treatment targets were LDL cholesterol of 68 mg/dl and non-HDL cholesterol of 92 mg/dl. In conclusion, non-HDL cholesterol is an adequate surrogate of ApoB during statin therapy, independent of triglyceride status. However, to match LDL cholesterol and ApoB treatment goals in the very-high-risk category, the current non-HDL cholesterol goal should be lowered by 8 to 10 mg/dl.

Authors+Show Affiliations

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

Pub Type(s)

Clinical Trial, Phase III
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23237107

Citation

Ballantyne, Christie M., et al. "Alteration of Relation of Atherogenic Lipoprotein Cholesterol to Apolipoprotein B By Intensive Statin Therapy in Patients With Acute Coronary Syndrome (from the Limiting UNdertreatment of Lipids in ACS With Rosuvastatin [LUNAR] Trial)." The American Journal of Cardiology, vol. 111, no. 4, 2013, pp. 506-9.
Ballantyne CM, Pitt B, Loscalzo J, et al. Alteration of relation of atherogenic lipoprotein cholesterol to apolipoprotein B by intensive statin therapy in patients with acute coronary syndrome (from the Limiting UNdertreatment of lipids in ACS With Rosuvastatin [LUNAR] Trial). Am J Cardiol. 2013;111(4):506-9.
Ballantyne, C. M., Pitt, B., Loscalzo, J., Cain, V. A., & Raichlen, J. S. (2013). Alteration of relation of atherogenic lipoprotein cholesterol to apolipoprotein B by intensive statin therapy in patients with acute coronary syndrome (from the Limiting UNdertreatment of lipids in ACS With Rosuvastatin [LUNAR] Trial). The American Journal of Cardiology, 111(4), 506-9. https://doi.org/10.1016/j.amjcard.2012.10.037
Ballantyne CM, et al. Alteration of Relation of Atherogenic Lipoprotein Cholesterol to Apolipoprotein B By Intensive Statin Therapy in Patients With Acute Coronary Syndrome (from the Limiting UNdertreatment of Lipids in ACS With Rosuvastatin [LUNAR] Trial). Am J Cardiol. 2013 Feb 15;111(4):506-9. PubMed PMID: 23237107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alteration of relation of atherogenic lipoprotein cholesterol to apolipoprotein B by intensive statin therapy in patients with acute coronary syndrome (from the Limiting UNdertreatment of lipids in ACS With Rosuvastatin [LUNAR] Trial). AU - Ballantyne,Christie M, AU - Pitt,Bertram, AU - Loscalzo,Joseph, AU - Cain,Valerie A, AU - Raichlen,Joel S, Y1 - 2012/12/10/ PY - 2012/08/07/received PY - 2012/10/22/revised PY - 2012/10/22/accepted PY - 2012/12/15/entrez PY - 2012/12/15/pubmed PY - 2013/4/16/medline SP - 506 EP - 9 JF - The American journal of cardiology JO - Am J Cardiol VL - 111 IS - 4 N2 - The low-density lipoprotein (LDL) cholesterol goal of <70 mg/dl, recommended for patients with acute coronary syndrome, typically requires intensive therapy with high-dose statins. The secondary goals of non-high-density lipoprotein (non-HDL) cholesterol <100 mg/dl and apolipoprotein B (ApoB) <80 mg/dl have been recommended to reduce excess cardiovascular risk not captured by LDL cholesterol. The present post hoc analysis from the Limiting UNdertreatment of lipids in Acute coronary syndrome with Rosuvastatin (LUNAR) study examined the relation of ApoB with LDL cholesterol and non-HDL cholesterol at baseline and during treatment with intensive statin therapy. The LUNAR participants had acute coronary syndrome and received rosuvastatin 40 mg/day or 20 mg/day or atorvastatin 80 mg/day for 12 weeks. Linear regression analyses were used to compare ApoB, direct LDL cholesterol, and non-HDL cholesterol at baseline and during therapy. Of the 682 patients included in the analysis, 220 had triglycerides ≥200 mg/dl. Linear regression analysis showed that correlation of ApoB and non-HDL cholesterol was stronger than that of ApoB and LDL cholesterol and stronger with statin therapy than at baseline (R(2) = 0.93 for ApoB vs non-HDL cholesterol with statins). The target of ApoB of 80 mg/dl correlated with LDL cholesterol of 90 mg/dl and non-HDL cholesterol of 110 mg/dl at baseline and with LDL cholesterol of 74 mg/dl and non-HDL cholesterol of 92 mg/dl with statin therapy. For high-triglyceride patients, the corresponding on-treatment targets were LDL cholesterol of 68 mg/dl and non-HDL cholesterol of 92 mg/dl. In conclusion, non-HDL cholesterol is an adequate surrogate of ApoB during statin therapy, independent of triglyceride status. However, to match LDL cholesterol and ApoB treatment goals in the very-high-risk category, the current non-HDL cholesterol goal should be lowered by 8 to 10 mg/dl. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/23237107/Alteration_of_relation_of_atherogenic_lipoprotein_cholesterol_to_apolipoprotein_B_by_intensive_statin_therapy_in_patients_with_acute_coronary_syndrome__from_the_Limiting_UNdertreatment_of_lipids_in_ACS_With_Rosuvastatin_[LUNAR]_Trial__ DB - PRIME DP - Unbound Medicine ER -