High Remnant Lipoprotein Predicts Recurrent Cardiovascular Events on Statin Treatment After Acute Coronary Syndrome

Background:After acute coronary syndrome (ACS), there is a high risk of recurrent cardiovascular events. Triglyceride-rich lipoproteins influence residual cardiovascular risk in patients taking statin. This study examined the predictive value of remnant lipoprotein level for secondary cardiovascular...

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Bibliographic Details
Published in:Circulation Journal 2014/09/25, Vol.78(10), pp.2492-2500
Main Authors: Nguyen, Si Van, Nakamura, Takamitsu, Kugiyama, Kiyotaka
Format: Article
Language:English
Subjects:
Acute coronary syndrome
Acute Coronary Syndrome - blood
Acute Coronary Syndrome - drug therapy
Acute Coronary Syndrome - mortality
Aged
Aged, 80 and over
Angina, Unstable - blood
Angina, Unstable - etiology
Angina, Unstable - mortality
Cholesterol - blood
Death
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Lipoproteins - blood
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - etiology
Myocardial Infarction - mortality
Prognosis
Prospective Studies
Remnant lipoprotein
Risk Factors
Statin
Triglycerides - blood
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Summary:Background:After acute coronary syndrome (ACS), there is a high risk of recurrent cardiovascular events. Triglyceride-rich lipoproteins influence residual cardiovascular risk in patients taking statin. This study examined the predictive value of remnant lipoprotein level for secondary cardiovascular events in patients treated with statins after ACS.Methods and Results:A total of 190 patients treated with statins after ACS were enrolled in the study. The serum level of remnant lipoproteins (remnant-like lipoprotein particle cholesterol; RLP-C) was measured using an immunoseparation method. All the patients were followed prospectively for a maximum period of 70 months or until the occurrence of one of the following events: cardiac death, non-fatal myocardial infarction, unstable angina requiring unplanned coronary revascularization, or ischemic stroke. During the follow-up period, 42 patients had a secondary event. Multivariate Cox analysis showed that a high level of RLP-C (≥5.4 mg/dl; determined on receiver operating characteristic curve analysis) was a significant risk factor for secondary events, independent of conventional risk factors (hazard ratio, 2.94; 95% confidence interval: 1.40–6.18; P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-14-0380