Author + information
- Donald Clark,
- Stephen Nicholls,
- Julie St. John,
- Mohamed Elshazly,
- Samir Kapadia,
- Murat Tuzcu,
- Steven Nissen and
- Rishi Puri
Background: Recent evidence suggests that higher visit-to-visit lipoprotein cholesterol variability associates with adverse cardiovascular outcomes, yet whether this phenomenon is proatherosclerotic remains unexplored. Serial intravascular ultrasonography (IVUS) permits examination of the effects of intra-individual lipid variability upon coronary atheroma progression.
Methods: We performed a post-hoc patient-level analysis of 9 trials involving 4,976 patients with coronary artery disease who underwent serial coronary IVUS in the setting of a range of medical therapies. The association between progression in percent atheroma volume (ΔPAV) and visit-to-visit lipid variability including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, total cholesterol (TC)/HDL-C, and apolipoprotein B (apoB) was assessed. Variability of lipid parameters was measured using intra-individual standard deviation (SD) over 3, 6, 12, 18, and 24 months.
Results: Higher visit-to-visit variability significantly associated with PAV progression for LDL-C, non-HDL-C, TC/HDL-C, and apoB. HDL-C variability did not associate with PAV progression (Figure 1).
Conclusions: Greater visit-to-visit variability in atherogenic lipoprotein levels significantly associates with coronary atheroma progression. Further research is required to elucidate mechanisms promoting lipoprotein variability, including its therapeutic implications.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-069
- 2017 American College of Cardiology Foundation