Levels and changes of HDL cholesterol and apolipoprotein A-I in relation to risk of cardiovascular events among statin-treated patients: a meta-analysis
Boekholdt SM, Arsenault BJ, Hovingh GK, Mora S, Pedersen TR, Larosa JC, Welch KM, Amarenco P, Demicco DA, Tonkin AM, Sullivan DR, Kirby A, Colhoun HM, Hitman GA, Betteridge DJ, Durrington PN, Clearfield MB, Downs JR, Gotto AM, Ridker PM, Kastelein JJ
Circulation · 160 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- NHLBI NIH HHS
- Subvenciones
- National Heart, Lung, and Blood Institute (R01HL117861)
Según 2 financiadores declarados.
Publicación
- Publicado
- 2013-08-21 · Circulation · vol. 128 · número 14 · págs. 1504–1512
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 196 citas · más que el 100% de estudios similares · 20.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 37 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cholesterol and Lipid Metabolism · Cancer, Lipids, and Metabolism
- Palabras clave
- HDL cholesterol, apolipoprotein A-I, statin therapy, cardiovascular risk, major cardiovascular events, low LDL cholesterol, lipid-lowering therapy
- MeSH
- humans, cardiovascular diseases, angina, unstable, myocardial infarction, triglycerides, apolipoprotein a-i, hydroxymethylglutaryl-coa reductase inhibitors, treatment outcome, proportional hazards models, risk factors, follow-up studies, risk reduction behavior, cholesterol, ldl, cholesterol, hdl, clinical trials as topic, heart failure, stroke, peripheral arterial disease
21 autores
- S. Matthijs Boekholdt🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Benoît J. Arsenault🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- G. Kees Hovingh🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Samia Mora🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Terje Rolf Pedersen🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- John C. LaRosa🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Kenneth M. A. Welch🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Pierre Amarenco🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- David A. DeMicco🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; Pfizer (United States); University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Andrew Maxwell Tonkin🇳🇴🇺🇸🇳🇱🇦🇺Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam; Monash University
- DAVID R. SULLIVAN🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Adrienne C Kirby🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Helen Martina Colhoun🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- G. A. Hitman🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- D. J. Betteridge🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Paul N. Durrington🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Michael B. Clearfield🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- D. J. Betteridge🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Antonio M. Gotto🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- Paul M. Ridker🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
- John J.P. Kastelein🇳🇴🇺🇸🇳🇱Oslo University Hospital; Brigham and Women's Hospital; State University of New York; University of Oslo; Rosalind Franklin University of Medicine and Science; Amsterdam UMC Location University of Amsterdam
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
It is unclear whether levels of high-density lipoprotein cholesterol (HDL-C) or apolipoprotein A-I (apoA-I) remain inversely associated with cardiovascular risk among patients who achieve very low levels of low-density lipoprotein cholesterol on statin therapy. It is also unknown whether a rise in HDL-C or apoA-I after initiation of statin therapy is associated with a reduced cardiovascular risk.
Methods and results
We performed a meta-analysis of 8 statin trials in which lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up. Individual patient data were obtained for 38,153 trial participants allocated to statin therapy, of whom 5387 suffered a major cardiovascular event. HDL-C levels were associated with a reduced risk of major cardiovascular events (adjusted hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.81-0.86 per 1 standard deviation increment), as were apoA-I levels (HR, 0.79; 95% CI, 0.72-0.82). This association was also observed among patients achieving on-statin low-density lipoprotein cholesterol levels <50 mg/dL. An increase of HDL-C was not associated with reduced cardiovascular risk (HR, 0.98; 95% CI, 0.94-1.01 per 1 standard deviation increment), whereas a rise in apoA-I was (HR, 0.93; 95% CI, 0.90-0.97).
Conclusions
Among patients treated with statin therapy, HDL-C and apoA-I levels were strongly associated with a reduced cardiovascular risk, even among those achieving very low low-density lipoprotein cholesterol. An apoA-I increase was associated with a reduced risk of major cardiovascular events, whereas for HDL-C this was not the case. These findings suggest that therapies that increase apoA-I concentration require further exploration with regard to cardiovascular risk reduction.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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