Effects on Coronary Atherosclerosis by Targeting Low-Density Lipoprotein Cholesterol with Statins

2009 ◽  
Vol 9 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Jean Ferrières
Keyword(s):  
Coronary Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

Abstract 5054: Apolipoprotein B, but not Low-Density Lipoprotein Cholesterol is Associated with Coronary Atherosclerosis Beyond Total Cholesterol in Diabetics and Non-Diabetics

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Seth S Martin ◽  
Atif N Qasim ◽  
Daniel J Rader ◽  
Muredach P Reilly
Keyword(s):  
Total Cholesterol ◽  
Apolipoprotein B ◽  
Coronary Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Type 2 Diabetics

Introduction: Accumulating evidence suggests that apolipoprotein B (apoB) is superior to low-density lipoprotein cholesterol (LDL-C) in prediction of cardiovascular events. Yet, an important outstanding question is whether apoB, relative to LDL, is an enhanced marker for subclinical atherosclerosis, particularly in diabetics where LDL levels may underestimate atherogenic lipid burden due to increased proportion of small, dense LDL. Hypothesis: We hypothesized that plasma apoB would be a better predictor than LDL-C of coronary artery calcification (CAC) scores in type 2 diabetics and non-type 2 diabetics. Methods: We performed cross-sectional analyses of asymptomatic Caucasians in (1) The Study of Inherited Risk of Coronary Atherosclerosis (434 men and 383 women; median age 48, non-diabetics) and (2) The Penn Diabetes Heart Study (580 men and 261 women; median age 60, type 2 diabetics). Results: Levels of apoB and LDL-C were correlated in diabetics (r=0.78, p<0.001) and non-diabetics (r=0.77, p<0.001). There was no association between LDL-C and CAC in diabetics. In non-diabetics, an association of LDL-C was lost after adjustment for total cholesterol. In contrast, after controlling for age, gender, statin therapy, and total cholesterol, levels of apoB were positively associated with CAC in diabetics [tobit regression ratio for 30 mg/dl increase in apoB 2.94 (95% CI 1.62 – 5.53), p=0.001) and had a more modest association with CAC in non-diabetics [1.67 (95% CI 1.16 – 2.32), p=0.005]. Conclusions: ApoB, but not LDL-C, predicted CAC scores, a measure of coronary atherosclerotic burden. The strength of this association was greater in diabetics than non-diabetics. Relative to LDL-C, plasma apoB levels may be particularly useful in assessing CVD risk in type 2 diabetes.

scholarly journals Independent role of low-density lipoprotein cholesterol in subclinical coronary atherosclerosis in the absence of traditional cardiovascular risk factors

2019 ◽  
Vol 20 (8) ◽  
pp. 866-872 ◽  
Author(s):  
Ki-Bum Won ◽  
Gyung-Min Park ◽  
Yu Jin Yang ◽  
Soe Hee Ann ◽  
Yong-Giun Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

Abstract Aims Individuals without traditional cardiovascular risk factors (CVRFs) still experience adverse events in clinical practice. This study evaluated the predictors of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Methods and results A total of 1250 (52.8 ± 6.5 years, 46.9% male) asymptomatic individuals without CVRFs who underwent coronary computed tomographic angiography for a general health examination were analysed. The following were considered as traditional CVRFs: systolic/diastolic blood pressure ≥140/90 mmHg; fasting glucose ≥126 mg/dL; total cholesterol ≥240 mg/dL; low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL; high-density lipoprotein cholesterol <40 mg/dL; body mass index ≥25.0 kg/m2; current smoking status; and previous medical history of hypertension, diabetes, and dyslipidaemia. Subclinical atherosclerosis, defined as the presence of any coronary plaque, was present in 20.6% cases; the incidences of non-calcified, calcified, and mixed plaque were 9.6%, 12.6%, and 2.6%, respectively. Multivariate regression analysis showed that LDL-C level [odds ratio (OR): 1.008; 95% confidence interval (CI): 1.001–1.015], together with age (OR: 1.101; 95% CI: 1.075–1.128) and male sex (OR: 5.574; 95% CI: 3.310–9.388), was associated with the presence of subclinical atherosclerosis (All P < 0.05). LDL-C level was significantly associated with an increased risk of calcified plaques rather than non-calcified or mixed plaques. Conclusion LDL-C, even at levels currently considered within normal range, is independently associated with the presence of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Our results suggest that a stricter control of LDL-C levels may be necessary for primary prevention in individuals who are conventionally considered healthy.

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