Remnant lipoproteinemia predicts cardiovascular events in patients with type 2 diabetes and chronic kidney disease
Open accessAbstract
Background Patients having type 2 diabetes mellitus (DM) and chronic kidney disease (CKD) are at high risk of cardiovascular events. Triglyceride-rich lipoprotein levels are synergistically increased in patients with DM and CKD. This study examined the predictive value of remnant lipoprotein levels for cardiovascular events in patients with DM and CKD.Methods Three hundred and sixty-five patients with type 2 DM and CKD were enrolled. Serum levels of remnant lipoproteins (remnant-like lipoprotein particles cholesterol; RLP-C) were measured by an immunoseparation method. All patients were followed prospectively for a period of 45±23 months or until occurrence of one of the following events: cardiac death, non-fatal myocardial infarction, unstable angina requiring unplanned coronary revascularization, or ischemic stroke.Results During the follow-up period, 59 patients had cardiovascular events. Multivariate Cox analysis revealed that high levels of RLP-C (≥4.3mg/dL; median value) were a significant risk factor for cardiovascular events, independent of traditional risk factors (HR: 1.30; 95% CI: 1.04-1.63; p=0.02). The addition of high levels of RLP-C to traditional risk factors improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.36, p=0.01; and IDI 0.03, p=0.02).Conclusions RLP-C is useful for risk assessment of future cardiovascular events in patients having type 2 DM and CKD.
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Measurement of remnant lipoprotein levels is useful for risk assessment in secondary prevention for patients with ACS who have undergone coronary interventions and are taking statins.
“Studies have shown that the measurement of remnant lipoprotein levels is useful for risk assessment in secondary prevention for patients with ACS who have undergone coronary interventions and are taking statins.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [241]
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- Authors
- Nguyen, S. V., Nakamura, T., Uematsu, M., Fujioka, D., Watanabe, K., Watanabe, Y., Obata, J.-E., Nakamura, K., & Kugiyama, K.
- Affiliations
- University of Yamanashi (JP)
- Corresponding author
- Kugiyama, Kiyotaka
- ORCID
- Venue
- Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 69
- Issue
- 3
- Pages
- 529-535
- ISSN
- 0914-5087 (ISSN-L)
- OpenAlex
- W2414191002
- Cited by
- 33
- References
- 41
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 2 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 2
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (26461059)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- type 2 diabetes, chronic kidney disease, cardiovascular events, cardiovascular risk prediction, triglyceride-rich lipoproteins, myocardial infarction, ischemic stroke, cardiovascular mortality, net reclassification improvement, integrated discrimination improvement
- MeSH terms
- Aged, Aged, 80 and over, Angina, Unstable, Cardiovascular Diseases, Cholesterol, Death, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Female, Humans, Lipoproteins, Male, Myocardial Infarction, Prospective Studies, Risk Factors, Triglycerides, Stroke, Renal Insufficiency, Chronic
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