Low-Density Lipoprotein Cholesterol, Non-High-Density Lipoprotein Cholesterol, Triglycerides & Apolipoprotein B and Cardiovascular Risk in Patients with Manifest Arterial Disease

Abstract Low-density lipoprotein cholesterol (LDL-C) only partly represents the atherogenic lipid burden and a growing body of evidence suggests that non-high-density lipoprotein cholesterol (non-HDL-C), triglycerides and apolipoprotein B (apoB) are more accurate in estimating lipid-related cardiova...

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Bibliographic Details
Published in:The American journal of cardiology 2016-09, Vol.118 (6), p.804-810
Main Authors: Johanneke van den Berg, M., MD, van der Graaf, Yolanda, MD, PhD, de Borst, Gert-Jan, MD, PhD, Kappelle, L. Jaap, MD, PhD, Nathoe, Hendrik M., MD, PhD, Visseren, Frank .L.J., MD, PhD
Format: Article
Language:English
Subjects:
Abdomen
Aged
Alcohol
Aneurysms
Angina pectoris
Angioplasty
Apolipoprotein B-100 - blood
Apolipoproteins
Atherosclerosis
Body mass index
Cardiovascular
Cardiovascular disease
Cardiovascular Diseases - blood
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Cerebrovascular Disorders - blood
Cerebrovascular Disorders - epidemiology
Cholesterol
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Cohort Studies
Confidence intervals
Coronary Artery Disease - blood
Coronary Artery Disease - epidemiology
Coronary vessels
Diabetes
Female
Health risk assessment
Heart attacks
Humans
Hypertension
Lipids
Low density lipoprotein
Male
Middle Aged
Mortality
Myocardial Infarction - blood
Myocardial Infarction - epidemiology
Netherlands - epidemiology
Patients
Peripheral Arterial Disease - blood
Peripheral Arterial Disease - epidemiology
Population
Prognosis
Proportional Hazards Models
Prospective Studies
Standard deviation
Stroke
Stroke - blood
Stroke - epidemiology
Studies
Triglycerides
Triglycerides - blood
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Summary:Abstract Low-density lipoprotein cholesterol (LDL-C) only partly represents the atherogenic lipid burden and a growing body of evidence suggests that non-high-density lipoprotein cholesterol (non-HDL-C), triglycerides and apolipoprotein B (apoB) are more accurate in estimating lipid-related cardiovascular disease risk. Our objective was to compare the relation between LDL-C, non-HDL-C, triglycerides and apoB and the occurrence of future vascular events and mortality in patients with manifest arterial disease. Prospective cohort study of 7216 patients with clinically manifest arterial disease in the Secondary Manifestations of ARTerial disease study. Cox proportional hazard models were used to quantify the risk of major cardiovascular events (MACE; i.e. stroke, myocardial infarction and vascular mortality) and all-cause mortality. Interaction was tested for type of vascular disease at inclusion. MACE occurred in 1185 subjects during a median follow-up of 6.5 years (interquartile range 3.4-9.9 years). Adjusted hazard ratios (HR) of MACE per 1SD higher were for LDL-C HR 1.15 (95%CI 1.09-1.22), for non-HDL-C HR 1.17 (95%CI 1.11-1.23), for log(triglycerides) HR 1.12 (95%CI 1.06-1.19) and for apoB HR 1.12 (95%CI 0.99-1.28). The relation between LDL-C, non-HDL-C and cardiovascular events was comparable in patients with cerebrovascular disease, coronary artery disease or polyvascular disease and absent in patients with aneurysm of abdominal aorta or peripheral artery disease. In conclusion, in patients with a history of cerebrovascular, coronary artery or polyvascular disease, but not aneurysm of abdominal aorta or peripheral artery disease, higher levels of LDL-C and non-HDL-C are related to increased risk of future MACE and of comparable magnitude.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2016.06.048