Cited by 83Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsLipid metabolism and disorders

Predictive value of remnant lipoprotein for cardiovascular events in patients with coronary artery disease after achievement of LDL-cholesterol goals

Nakamura, Takamitsu, Obata, Jun-ei, Hirano, Mitsumasa, Kitta, Yoshinobu, Fujioka, Daisuke, Saito, Yukio, Kawabata, Ken-ichi, Watanabe, Kazuhiro +3 more·2011·Atherosclerosis

Abstract

Objectives 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 levels <100mg/dL on lipid-lowering therapy.Methods 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 levels <100mg/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.Results 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, p<0.01). 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.Conclusions RLP-C was superior to non-HDL-C for predicting cardiovascular events in CAD patients with LDL-C levels <100mg/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.

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Crossref · 10.1016/j.atherosclerosis.2011.04.040

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Authors
Nakamura, T., Obata, J.-E., Hirano, M., Kitta, Y., Fujioka, D., Saito, Y., Kawabata, K.-I., Watanabe, K., Watanabe, Y., Mishina, H., & Kugiyama, K.
Affiliations
University of Yamanashi Hospital (JP)
Corresponding author
Kugiyama, Kiyotaka
Venue
Atherosclerosis
Publisher
Elsevier BV
Published
2011-09
Volume
218
Issue
1
Pages
163-167
ISSN
0021-9150 (ISSN-L)
OpenAlex
W2032275737
Cited by
83
References
30
Citations by year
2026: 4 · 2025: 5 · 2024: 8 · 2023: 11 · 2022: 9 · 2021: 4 · 2020: 6 · 2019: 5 · 2018: 5 · 2017: 1 · 2016: 5 · 2015: 6 · 2014: 5 · 2013: 5 · 2012: 4
FWCI
4.57
Type
journal article
Language
en
Open access
closed
Locations
  • Atherosclerosis (publishedVersion)
  • PubMed (publishedVersion)
Funders
Otsuka Pharmaceutical
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords
remnant lipoproteins, coronary artery disease, cardiovascular events, residual cardiovascular risk, LDL cholesterol targets, lipid-lowering therapy, non-HDL cholesterol, apolipoprotein B, triglyceride-rich lipoproteins, cardiovascular risk prediction, myocardial infarction, ischemic stroke, cardiovascular mortality
MeSH terms
Aged, Apolipoproteins B, Cardiology, Cardiovascular Diseases, Cholesterol, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Lipoproteins, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Predictive Value of Tests, Risk Factors, Triglycerides, Proportional Hazards Models

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