Cited by 12Lipoproteins and Cardiovascular HealthAcute Ischemic Stroke ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

On-treatment lipoprotein components and risk of cerebrovascular events in the Treating to New Targets study

van den Bogaard, Bas, van den Born, Bert-Jan H., Fayyad, Rana, Waters, David D., DeMicco, David A., LaRosa, John C., Kastelein, John J. P., Holme, Ingar +1 more·2011·European Journal of Clinical Investigation

Abstract

BACKGROUND: The Treating to New Targets (TNT) study has recently provided evidence that reduction in LDL-C levels below 2·6 mmol L⁻¹ lowers the risk of cerebrovascular events by an additional 20% to 25%, thereby confirming the value of statin therapy in preventing transient ischaemic attacks and stroke. Despite the protective effects of statin therapy, the epidemiological association between lipid components and cerebrovascular events is less clear. We therefore assessed the strength of association between in-trial lipoprotein components and cerebrovascular disease in patients receiving intensive lipid-lowering therapy. METHODS: In 9247 patients (mean age 61·0 years, 81·2% males), the association between lipoprotein components and the risk of cerebrovascular events after the first year into the TNT trial was assessed after stratification of lipoprotein components into approximate quartiles. Cox proportional hazards models were used to explore the association between lipoprotein components and time to first cerebrovascular event after adjustment for potential confounding variables. RESULTS: All lipoprotein components, except LDL-C, showed a significant gradient for incidence of cerebrovascular events with increasing quartiles of the lipoprotein component. If the lipoprotein components were treated as continuous variables, the adjusted hazard ratios (95% CI) for cerebrovascular events for 1 SD difference in 1-year lipoprotein components were 1·13 (1·02-1·25) for LDL-C, 0·86 (0·76-0·97) for HDL-C, 1·17 (1·04-1·28) for apoB, 0·83 (0·74-0·94) for apoA-1, 1·22 (1·10-1·34) for TC/HDL-C and 1·24 (1·12-1·37) for apoB/apoA-1. CONCLUSIONS: In coronary heart disease patients receiving intensive lipid-lowering treatment, the on-treatment apoB/apoA-1 ratio provides the strongest association with incidence of cerebrovascular events followed by TC/HDL-C.

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Crossref · 10.1111/j.1365-2362.2010.02387.x

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Authors
van den Bogaard, B., van den Born, B.-J. H., Fayyad, R., Waters, D. D., DeMicco, D. A., LaRosa, J. C., Kastelein, J. J. P., Holme, I., & On behalf of the Treating to New Targets investigators
Affiliations
  • Pfizer (United States) (US)
  • University of California, San Francisco (US)
  • State University of New York (US)
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Oslo University Hospital (NO)
Venue
European Journal of Clinical Investigation
Publisher
Wiley
Published
2010-09-27
Volume
41
Issue
2
Pages
134-142
ISSN
0014-2972 (ISSN-L)
OpenAlex
W1588172340
Cited by
12
References
24
Citations by year
2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2017: 1 · 2012: 1
FWCI
1.01
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Clinical Investigation (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
cerebrovascular events, LDL cholesterol, HDL cholesterol, apolipoprotein B, apolipoprotein A-I, TC/HDL-C ratio, ApoB/ApoA1 ratio, intensive lipid-lowering therapy, statin therapy, coronary artery disease, stroke, transient ischemic attack, risk factors
MeSH terms
Aged, Anticholesteremic Agents, Ischemic Attack, Transient, Coronary Disease, Female, Follow-Up Studies, Humans, Lipoproteins, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Risk Factors, Time Factors, Proportional Hazards Models, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Stroke

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