scholarly journals Haptoglobin Phenotype Modifies the Effect of Fenofibrate on Risk of Coronary Event: ACCORD Lipid Trial

2021 ◽  
Author(s):  
Rachel A Warren ◽  
Allie S Carew ◽  
Pantelis Andreou ◽  
Christine Herman ◽  
Andrew P Levy ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Coronary Event ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Artery Disease ◽  
Design And Methods ◽  
The Relationship ◽  
Cad Risk

Objective: The haptoglobin (Hp)2-2 phenotype (~35-40% of people) is associated with increased oxidation and dysfunctional high-density lipoprotein (HDL) in hyperglycemia and may explain why drugs designed to pharmacologically raise HDL-cholesterol and lower triglycerides have not reliably prevented cardiovascular disease (CVD) in diabetes. We aimed to determine whether the effect of adding fenofibrate versus placebo to simvastatin on the risk of coronary artery disease (CAD) events depends on Hp phenotype in the ACCORD lipid trial (NCT00000620). <p>Research Design and Methods: Cox proportional hazards regression models quantitfied the relationship between fenofibrate therapy and CAD events in the ACCORD lipid trial in participants with the Hp2-2 phenotype (n=1,795) separately from those without (n=3,201). </p> <p>Results: Fenofibrate therapy successfully lowered the risk of CAD events in participants without the Hp2-2 phenotype (multivariable-adjusted hazard ratio: 0.74, 95% CI: 0.60-0.90, compared to no fenofibrate therapy) but not in participants with the Hp2-2 phenotype (1.16, 0.87-1.56, p, interaction=0.009). Subgroup analyses revealed that this protective effect of fenofibrate against CAD events among the non-Hp2-2 phenotype group was most effective in participants with severe dyslipidemia (p, interaction=0.01), and and in males (p, interaction= 0.02) with an increased CAD risk from fenofibrate treatment observed in females with the Hp2-2 phenotype (p, interaction= 0.002). </p> <p>Conclusions: The effect of fenofibrate added to simvastatin on risk of CAD events depends on Hp phenotype in the ACCORD lipid trial. </p>

scholarly journals Haptoglobin Phenotype Modifies the Effect of Fenofibrate on Risk of Coronary Event: ACCORD Lipid Trial

2021 ◽  
Author(s):  
Rachel A Warren ◽  
Allie S Carew ◽  
Pantelis Andreou ◽  
Christine Herman ◽  
Andrew P Levy ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Coronary Event ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Artery Disease ◽  
Design And Methods ◽  
The Relationship ◽  
Cad Risk

Objective: The haptoglobin (Hp)2-2 phenotype (~35-40% of people) is associated with increased oxidation and dysfunctional high-density lipoprotein (HDL) in hyperglycemia and may explain why drugs designed to pharmacologically raise HDL-cholesterol and lower triglycerides have not reliably prevented cardiovascular disease (CVD) in diabetes. We aimed to determine whether the effect of adding fenofibrate versus placebo to simvastatin on the risk of coronary artery disease (CAD) events depends on Hp phenotype in the ACCORD lipid trial (NCT00000620). <p>Research Design and Methods: Cox proportional hazards regression models quantitfied the relationship between fenofibrate therapy and CAD events in the ACCORD lipid trial in participants with the Hp2-2 phenotype (n=1,795) separately from those without (n=3,201). </p> <p>Results: Fenofibrate therapy successfully lowered the risk of CAD events in participants without the Hp2-2 phenotype (multivariable-adjusted hazard ratio: 0.74, 95% CI: 0.60-0.90, compared to no fenofibrate therapy) but not in participants with the Hp2-2 phenotype (1.16, 0.87-1.56, p, interaction=0.009). Subgroup analyses revealed that this protective effect of fenofibrate against CAD events among the non-Hp2-2 phenotype group was most effective in participants with severe dyslipidemia (p, interaction=0.01), and and in males (p, interaction= 0.02) with an increased CAD risk from fenofibrate treatment observed in females with the Hp2-2 phenotype (p, interaction= 0.002). </p> <p>Conclusions: The effect of fenofibrate added to simvastatin on risk of CAD events depends on Hp phenotype in the ACCORD lipid trial. </p>

scholarly journals LDL/HDL cholesterol ratio is associated with new-onset NAFLD in Chinese non-obese people with normal lipids: a 5-year longitudinal cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yang Zou ◽  
Ling Zhong ◽  
Chong Hu ◽  
Mingchun Zhong ◽  
Nan Peng ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cox Proportional Hazards ◽  
Obese People ◽  
Cholesterol Ratio ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
New Onset

Abstract Background Low-density lipoprotein to high density lipoprotein (LDL/HDL) cholesterol ratio has been reported to predict the risk of many metabolic diseases. However, the association between the LDL/HDL cholesterol ratio and nonalcoholic fatty liver disease (NAFLD) has not been established. Methods A longitudinal cohort design was adopted in this study; 9767 non-obese subjects without NAFLD were included and analyzed. The subjects were grouped according to the quintile of LDL/HDL cholesterol ratio. The cumulative incidence of NAFLD and the independent effect of the LDL/HDL cholesterol ratio on NAFLD during 5 years of follow-up were calculated using the Kaplan-Meier method and Cox proportional-hazards regression model. Results During the 5-year follow-up period, 841 subjects were diagnosed with new-onset NAFLD, and the 1-, 2-, 3-, 4-, and 5-year cumulative incidence rates of NAFLD were 1.16, 4.65, 8.33, 12.43, and 25.14%, respectively. In the multivariable-adjusted Cox proportional-hazards regression model, the LDL/HDL cholesterol ratio was significantly associated with the risk for NAFLD (HR: 1.66, 95% CI: 1.38–1.99, P trend< 0.001), especially among young people (HR: 3.96, 95% CI: 1.50–10.46, P interaction< 0.05). Additionally, receiver operating characteristic curve analysis showed that the LDL/HDL cholesterol ratio was better than HDL cholesterol and LDL cholesterol in predicting new-onset NAFLD. Conclusions LDL/HDL cholesterol ratio is an independent predictor of NAFLD in Chinese non-obese people with normal lipids, and its predictive value is higher than that of other lipoproteins. In clinical practice, the LDL/HDL cholesterol ratio can be used to identify people at high risk of NAFLD.

Serum FGF21 Is Associated with Future Cardiovascular Events in Patients with Coronary Artery Disease

Cardiology ◽  
2018 ◽  
Vol 139 (4) ◽  
pp. 212-218 ◽  
Author(s):  
Yun Shen ◽  
Xueli Zhang ◽  
Yiting Xu ◽  
Qin Xiong ◽  
Zhigang Lu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Artery Disease

Objectives: To investigate whether serum fibroblast growth factor 21 (FGF21) levels can be used to predict the future development of major adverse cardiovascular events (MACEs). Methods: This study included 253 patients who received subsequent follow-up, and complete data were collected for 234 patients. Independent predictors of MACEs were identified by using the Cox proportional-hazards regression analysis. The prognostic value of FGF21 levels for MACEs was evaluated by Kaplan-Meier survival analysis. Results: Of 229 patients finally enrolled in the analysis, 27/60 without coronary artery disease (CAD) at baseline experienced a MACE, and 132/169 patients with CAD at baseline experienced a MACE. Among patients with CAD at baseline, serum FGF21 levels were significantly higher in patients with MACEs (p < 0.05) than in patients without MACEs. Kaplan-Meier survival analysis showed patients with a higher serum FGF21 had a significantly lower event-free survival (p = 0.001) than those with a lower level. Further Cox proportional-hazards regression analysis, including the traditional risk factors for cardiovascular disease, showed that serum FGF21 was an independent predictor of MACE occurrence. Conclusions: In patients with CAD at baseline, an elevated serum FGF21 level was associated with the development of a MACE in the future.

The association between lymphopenia and serious infection risk in rheumatoid arthritis

Rheumatology ◽  
2019 ◽  
Vol 59 (4) ◽  
pp. 762-766
Author(s):  
Sujith Subesinghe ◽  
Alexander Kleymann ◽  
Andrew Ian Rutherford ◽  
Katie Bechman ◽  
Sam Norton ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Mixed Effect ◽  
Proportional Hazards Regression ◽  
Effect Model ◽  
Serious Infection ◽  
Patients At Risk ◽  
Using Data ◽  
The Relationship

Abstract Objectives To investigate the relationship between occurrence of serious infection (SI) and lymphocyte counts in patients with RA using data from a single centre. Methods We used routinely captured data from a single tertiary rheumatology centre to explore the relationship between lymphopenia and SI risk. Adult RA patients were included over a 5-year follow-up period. Admissions due to confirmed SI were considered. SI rate with 95% confidence intervals was calculated. The association between SI with baseline lymphocyte counts, time-averaged lymphocyte counts throughout all follow-up, and a nadir lymphocyte count was assessed using Cox proportional hazards regression. The relationship between lymphopenia over time and SI was analysed using a mixed-effect model of lymphocyte counts prior to SI. Results This analysis included 1095 patients with 205 SIs during 2016 person-years of follow-up. The SI rate was 4.61/100 patient-years (95% CI: 3.76, 5.65). Compared with patients with nadir lymphocyte counts &gt;1.5 × 109 cells/l, nadir lymphopenia &lt;1 × 109 cells/l was significantly associated with higher SI risk (HR 3.28; 95% CI: 1.59, 6.76), increasing to HR 8.08 (95% CI: 3.74, 17.44) in patients with lymphopenia &lt;0.5 × 109 cells/l. Lymphocyte counts were observed to be reduced in the 30-day period prior to SI. Conclusion Lymphocyte counts below &lt;1.0 × 109 cells/l were associated with higher SI risk in RA patients; the strongest association between lymphopenia and SI was observed when lymphocyte counts were below &lt;0.5 × 109 cells/l. Lymphopenia may be used as a measure to stratify patients at risk of SI.

scholarly journals Effects of Low-density Lipoprotein Cholesterol on Cardiovascular Disease and All-cause Mortality in Elderly Patients (≥75 years old)

2021 ◽  
Author(s):  
Jiaxin Yu ◽  
xiaokun liu ◽  
shuohua chen ◽  
yan liu ◽  
hongmin liu ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cox Proportional Hazards ◽  
Cvd Risk ◽  
Proportional Hazards Regression ◽  
All Cause Mortality ◽  
Level Group ◽  
The Ideal

Abstract Background: The associations of low-density lipoprotein cholesterol (LDL-C) with cardiovascular disease (CVD) and all-cause mortality are unclear in elderly(≥75 years) Chinese individuals.Methods: A total of 3674 individuals aged 75 or older underwent medical examinations at the Kailuan Group in 2006. Participants were divided into three groups by LDL_C values: the ideal level (LDL-C <2.6 mmol/l), appropriate level (2.6 mmol/l≤ LDL-C＜3.4 mmol/l) and elevated level (LDL-C≥3.4 mmol/l) groups. CVD and all-cause mortality events were recorded during the follow-up period. The Cox proportional hazards regression model was applied to evaluate the effect of LDL-C on CVD and all-cause mortality events.Results: The average follow-up time was 9.87±3.60 years.After adjustment for confounding factors, the multivariate Cox proportional hazards regression model showed that CVD risk in the elevated group was 1.46 (95% CI, 1.08-1.97), acute myocardial infarction risk was 2.08 (95% CI, 1.26-3.44), and all-cause mortality risk in the appropriate level group and elevated group was 1.12 (95% CI, 1.00-1.25) and 1.17 (95% CI, 1.00-1.36), respectively, compared with those in the ideal level group. For every standard deviation increase in LDL-C, CVD risk increased by 10%, acute myocardial infarction risk increased by 21%, and all-cause mortality event risk increased by 4%. No association was found between elevated LDL-C levels and the risk of stroke.Conclusions: In the elderly population, elevated LDL-C levels are a risk factor for CVD and all-cause mortality.

Association of triglyceride to HDL cholesterol ratio with cardiometabolic outcomes

2018 ◽  
Vol 67 (3) ◽  
pp. 663-668
Author(s):  
May Yang ◽  
Joseph Rigdon ◽  
Sandra A Tsai
Keyword(s):  
Type 2 Diabetes ◽  
Proportional Hazards ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cox Proportional Hazards ◽  
Cholesterol Ratio ◽  
Cox Proportional Hazards Models ◽  
Potential Opportunity

Electronic medical records (EMRs) offer a potential opportunity to identify patients at high risk for cardiometabolic disease, which encompasses type 2 diabetes and cardiovascular disease (CVD). The objective of this retrospective cohort study is to use information gathered from EMR to investigate the association between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and cardiometabolic outcomes in a general population of subjects over 50 years of age during a follow-up period of 8–9 years. TG/HDL-C was recorded for each of 1428 subjects in 2008, and diagnoses of type 2 diabetes and CVD were recorded through chart review until 2017. Cox proportional hazards models controlling for demographic characteristics and other risk factors demonstrated that high TG/HDL-C (>2.5 in women or >3.5 in men) was significantly associated with increased incidence of type 2 diabetes (HR 1.66; 95% CI 1.07 to 2.57; p=0.0230). There was also a suggested association between high TG/HDL-C and incidence of CVD (HR 1.51; 95% CI 0.98 to 2.35; p=0.0628). These findings suggest that using TG/HDL-C, which can be easily calculated from data in an EMR, should be another tool used in identifying patients at high cardiometabolic risk.

scholarly journals Serum Lipids, Apolipoproteins, and Mortality among Coronary Artery Disease Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Ding Ding ◽  
Xinrui Li ◽  
Jian Qiu ◽  
Rui Li ◽  
Yuan Zhang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Proportional Hazards ◽  
Density Lipoprotein ◽  
Cox Proportional Hazards ◽  
Lipoprotein Cholesterol ◽  
Study Cohort ◽  
Cvd Risk ◽  
Artery Disease ◽  
Cvd Mortality

The proatherogenic effect of low-density lipoprotein cholesterol (LDL-C) and antiatherogenic effect of high-density lipoprotein cholesterol (HDL-C) have been confirmed in general population. But controversy arises among coronary artery disease (CAD) patients. The goal of this study was to identify the association of different lipid measurements with CAD prognosis. The study cohort included 1916 CAD patients who were 40–85 years of age. Cox proportional hazards regression models were used to estimate the association of baseline 6 lipid factors and 3 ratios with all-cause and cardiovascular (CVD) mortality. During a median follow-up of 3.1 years, 147 deaths were recorded, 113 of which were due to CVD. When lipid factors were categorized, HDL-C showed a U-shape association with all-cause and CVD mortality after adjustment for major CVD risk factors. Serum LDL-C, apoB, LDL/HDL ratio, and apoB/apoA-I ratio were positively, and apoA-I level was inversely associated with the risk of CVD mortality. After further pairwise comparison of lipid-related risk, LDL/HDL ratio and LDL-C had stronger association with all-cause and CVD mortality than other proatherogenic measurements among Chinese CAD patients.

scholarly journals Association of Coffee Consumption and Its Types According to Addition of Sugar and Creamer with Metabolic Syndrome Incidence in a Korean Population from the Health Examinees (HEXA) Study

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 920
Author(s):  
Li-Juan Tan ◽  
Hye Joo Jeon ◽  
SoHyun Park ◽  
Seong-Ah Kim ◽  
Kyungjoon Lim ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Chronic Diseases ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Fasting Blood Glucose ◽  
Coffee Consumption ◽  
Density Lipoprotein ◽  
Cox Proportional Hazards ◽  
Low Hdl ◽  
The Relationship

Coffee is widely consumed worldwide, and numerous studies indicate that coffee consumption may potentially affect the development of chronic diseases. Metabolic syndrome (MetS) may constitute a risk factor for chronic diseases. We aimed to prospectively evaluate the association between coffee consumption and MetS incidence. All participants were selected from the Health Examinees study. MetS was defined by the Adult Treatment Panel III criteria of the National Cholesterol Education Program. A multivariate Cox proportional hazards regression model was used to assess the relationship between coffee consumption and MetS incidence. In comparison with non-consumers, male moderate consumers (≤3 cups/day) showed a lower risk for low high-density lipoprotein cholesterol (HDL-C) (≤1 cup/day, hazard ratio (HR): 0.445, 95% confidence interval (CI): 0.254–0.780; 1–3 cups/day, HR: 0.507, 95% CI: 0.299–0.859) and high fasting blood glucose (FPG) (≤1 cup/day, HR: 0.694, 95% CI: 0.538–0.895; 1–3 cups/day, HR: 0.763, 95% CI: 0.598–0.972). Male 3-in-1 coffee (coffee with sugar and creamer) consumers also showed a lower risk for low HDL-C (HR: 0.423, 95% CI: 0.218–0.824) and high FPG (HR: 0.659, 95% CI: 0.497–0.874). These findings indicate a negative association between moderate coffee consumption and low HDL-C and high FPG among Korean male adults.

scholarly journals Prognostic Significance of HbA1c Level in Asian Patients with Prediabetes and Coronary Artery Disease

2021 ◽  
Author(s):  
Yujie Zhou
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hba1c Level ◽  
Proportional Hazards ◽  
Prognostic Significance ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Regression ◽  
Asian Patients ◽  
Proportional Hazards Regression ◽  
Artery Disease

Background: Measuring glycosylated hemoglobin (HbA1c) is a simple way to assess patients with prediabetes ordiabetes mellitus. It has been shown that HbA1c level predicts prognosis in patients with coronary artery disease (CAD)and the incidence of diabetes mellitus. However, the prognostic significance of HbA1c level in Asian patients withprediabetes and CAD is not yet clear. Our study aimed to determine the relationship between HbA1c level and majoradverse cardiovascular events (MACE) in patients with prediabetes and CAD.Methods: We enrolled 1367 patients with prediabetes and CAD in the final analysis, and grouped them according tothe HbA1c level. Primary end points included nonfatal myocardial infarction, hospitalization for unstable angina, andischemia-driven revascularization. Cox proportional-hazards regression analysis was used to determine the relationshipbetween HbA1c level and MACE after our accounting for confounding factors.Results: A total of 1367 patients (age 58.8 ± 10.3 years; 71.6% men) were included. During 43 months of follow-up,197 patients experienced at least one primary end point event. Multivariate Cox proportional-hazards regression analysisshowed in comparison of HbA1c levels that the hazard ratio for primary end points was 4.110, with a 95% confidence interval of 2.097–6.011 (P < 0.001).Conclusions: HbA1c level positively correlated with MACE, demonstrating it is a valuable indicator for independentlypredicting MACE in Asian patients with prediabetes and CAD.

scholarly journals PCSK9 E670G polymorphism increases risk of coronary artery disease in a Chinese Han population

2019 ◽  
pp. 030006051989217 ◽  
Author(s):  
Zhang Lin ◽  
Shi Hong Wang ◽  
Da Yong Wei ◽  
Lu Min Wang ◽  
Zhong Wu Zhang
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Genetic Model ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Case Control Studies ◽  
Chinese Han ◽  
Artery Disease ◽  
The Relationship ◽  
Cad Risk

Objective Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the world. The proprotein convertase subtilisin/kexin type 9 ( PCSK9) E670G polymorphism has been reported to be associated with variability in levels of low density lipoprotein cholesterol, a risk factor for CAD. However, the relationship between PCSK9 E670G and CAD is still not fully elucidated. Methods A total of 225 patients and 189 control subjects were recruited in this study. DNA was extracted from peripheral blood samples and was genotyped by mass array method. In addition, we also conducted a meta-analysis of case-control studies to elucidate the relationship of CAD and polymorphism. Results The GG genotype of PCSK9 E670G was associated with a higher risk of CAD [odds ratio (OR) 2.994, 95% confidence interval (CI): 1.174–7.631], even adjusting for risk factors (OR 2.794, 95% CI: 1.215–7.460). Logistic regression analysis showed that the dominant genetic model increased the CAD risk (OR 2.313, 95% CI: 1.070–6.983) after adjusting the confounding factors. Meta-analysis results of 13 studies revealed that PCSK9 E670G polymorphism was correlated with CAD risk under different genetic models. Conclusion Our results demonstrated that PCSK9 E670G genotype was associated with a high risk of CAD.

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