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Atherosclerosis. 2010 Feb;208(2):484-9. doi: 10.1016/j.atherosclerosis.2009.08.026. Epub 2009 Aug 21.

Factors predicting cardiovascular events in statin-treated diabetic and non-diabetic patients with coronary atherosclerosis.

Author information

1
Vorarlberg Institute for Vascular Investigation and Treatment, Academic Teaching Hospital Feldkirch, Carinagasse 47, A-6807 Feldkirch, Austria. vivit@lkhf.at

Abstract

OBJECTIVE:

We aimed at identifying which lipid factors drive vascular risk in statin-treated patients with coronary artery disease (CAD).

METHODS:

We recorded vascular events over 5.6 years in 491 consecutive statin-treated patients with angiographically proven stable CAD, covering 2750 patient-years.

RESULTS:

In the total population, low high-density lipoprotein (HDL) cholesterol (standardized adjusted HR 0.73 [0.60-0.89]; p=0.001), low apolipoprotein A1 (0.77 [0.65-0.92]; p=0.003), a small low-density lipoprotein (LDL) particle diameter (0.76 [0.64-0.91]; p=0.002), and high triglycerides (1.20 [1.05-1.38]; p=0.007) predicted vascular events, but not total cholesterol, LDL cholesterol, or apolipoprotein B. Factor analysis in the lipid profiles of our patients revealed an HDL-related factor and an LDL-related factor. Concordant with the results for individual lipid parameters, the HDL-related factor (0.69 [0.58-0.83]; p<0.001) but not the LDL-related factor (p=0.455) predicted vascular events. Patients with type 2 diabetes (T2DM; n=116) were at a higher vascular risk than non-diabetic subjects (38.6% vs. 24.1%; p<0.001), and like in the total population the HDL-related factor (0.59 [0.44-0.77]; p<0.001) but not the LDL-related factor (p=0.591) predicted vascular risk in diabetic patients.

CONCLUSIONS:

The pattern of low HDL cholesterol, low apolipoprotein A1, small LDL particles, and high triglycerides drives vascular risk in statin-treated coronary patients, particularly in those with T2DM.

[Indexed for MEDLINE]

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