Author + information
Low density lipoprotein cholesterol (LDL-C) has long been the cornerstone of lipid lowering therapy for atherosclerosis risk reduction. However, recent investigations have reported the importance of subfractions and other atherogenic lipoproteins in reducing risk. We evaluated the predictive ability of atherogenic lipoproteins and subfractions among a higher risk cohort for the occurrence of death, myocardial infarction (MI), and repeat revascularization (MACE).
A total of 2,414 patients of the registry of the Intermountain Heart Study were evaluated. At time of angiography, lipid and subfractions were measured using the Vertical Auto Profile method (Atherotech; Birmingham, AL). Cox hazard regression was utilized to determine the association between lipid parameters and MACE adjusted by cardiac risk factors, medications, and lipids and subparticles. Average length of follow-up was 4.0±2.3 years.
Age averaged 62.6±12.6 years, 65.5% were male, 54.2% had hyperlipidemia, 20.3% were diabetic, and 53.9% had angiographic CAD. Average LDL-C and non-HDL were 102.2±35.5 mg/dL and 131.5±39.8 mg/dL, respectively. The Table displays univariable and levels of multivariable analysis for the association of lipids and subfractions to MACE.
After adjustment, only the denser LDL (LDL3 and LDL4) and apolipoprotein B were significant predictors of MACE. The role of lipoproteins and subfractions for adverse outcomes in higher risk patients needs further study.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: Lipoproteins, Particles and Ratios
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1145-1
- 2013 American College of Cardiology Foundation