Non–High-Density Lipoprotein Cholesterol Levels Predict Five-Year Outcome in the Bypass Angioplasty Revascularization Investigation (BARI)
Abstract
Background— Current National Cholesterol Education Program guidelines recommend that non–high-density lipoprotein cholesterol (non-HDL-C) be considered a secondary target of therapy among individuals with triglycerides >2.26 mmol/L. It is not known whether non-HDL-C relates to prognosis among patients with coronary heart disease. Methods and Results— Lipid levels were available at baseline among 1514 patients (73% men; mean age, 61 years) enrolled in the Bypass Angioplasty Revascularization Investigation (BARI); all had multivessel coronary artery disease. Patients were followed for 5 years. Outcomes of death, nonfatal myocardial infarction, and death or myocardial infarction were modeled using univariate and multivariate time-dependent proportional hazards methods; angina pectoris at 5 years was modeled using univariate and multivariate logistic regression. Non-HDL-C was a strong and independent predictor of nonfatal myocardial infarction (multivariate relative risk, 1.049 [95% confidence intervals, 1.006 to 1.093] for every 0.26 mmol/L increase) and angina pectoris (multivariate odds ratio, 1.049 [95% confidence intervals, 1.004 to 1.096] for every 0.26 mmol/L increase), but it did not relate to mortality. HDL-C and LDL-C did not predict events during follow-up. Conclusions— Among patients with lipid values in BARI, non-HDL-C is a strong and independent predictor of nonfatal myocardial infarction and angina pectoris at 5 years, even after consideration of powerful clinical variables. Our data suggest that non-HDL-C is an appropriate treatment target among patients with coronary heart disease.
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The value of non-HDL-C in CVD risk assessment was first proposed by Frost and Havel in 1998, and this relationship has now been confirmed in many studies.
“The value of non-HDL-C in CVD risk assessment was first proposed by Frost and Havel in 1998, 61 and this relationship has now been confirmed in many studies. [203]3][204][205][206][207][208][209][210][211][212][213][214][215][216]”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [211]
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- Authors
- Bittner, V., Hardison, R., Kelsey, S. F., Weiner, B. H., Jacobs, A. K., & Sopko, G.
- Affiliations
- Boston University (US)
- Venue
- Circulation
- Published
- 2002-11-12
- Volume
- 106
- Issue
- 20
- Pages
- 2537-2542
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2113541168
- Cited by
- 168
- References
- 16
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 5 · 2021: 1 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 7 · 2016: 9 · 2015: 6 · 2014: 5 · 2013: 13 · 2012: 4
- FWCI
- 9.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5u01hl038532-11, 5u01hl038504-10, 5u01hl038556-10, 5u01hl038512-10, 5u01hl038642-11, 2u01hl038514-09, 5u01hl038509-10, 5u01hl038518-11, 5u01hl038529-11, 2u01hl038524-09, 2u01hl038493-09)
- National Heart, Lung, and Blood Institute (HL 38610, HL-38509, HL42145, HL-38529, HL38514-6, HL38556, HL-38493, HL-38532, HL38642, HL-38504, HL-38518, HL 38512, U01HL038610, HL38524)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Keywords
- non-HDL cholesterol, coronary artery disease, multivessel coronary artery disease, nonfatal myocardial infarction, angina pectoris, cardiovascular mortality, prognostic factors, triglycerides, HDL cholesterol, LDL cholesterol
- MeSH terms
- Angina Pectoris, Coronary Artery Bypass, Cholesterol, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Lipoproteins, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Myocardial Infarction, Prognosis, Risk, Triglycerides, Angioplasty, Balloon, Coronary, Treatment Outcome
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