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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| Veröffentlicht in: | Circulation Journal 2014/09/25, Vol.78(10), pp.2492-2500 |
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| creator | Nguyen, Si Van Nakamura, Takamitsu Kugiyama, Kiyotaka |
| description | 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 |
| doi_str_mv | 10.1253/circj.CJ-14-0380 |
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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<0.01). The addition of high RLP-C to traditional risk factors enhanced net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI, 0.66, P=0.0003; and IDI, 0.08, P=0.0002).Conclusions:RLP-C is useful for risk assessment of secondary cardiovascular events in patients treated with statins after ACS. (Circ J 2014; 78: 2492–2500)</description><identifier>ISSN: 1346-9843</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-14-0380</identifier><identifier>PMID: 25168189</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>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</subject><ispartof>Circulation Journal, 2014/09/25, Vol.78(10), pp.2492-2500</ispartof><rights>2014 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c678t-3efa2016ce8d7e1b60e9414eeae8055204e2e409ef739cda9cd036f0dd7cc1433</citedby><cites>FETCH-LOGICAL-c678t-3efa2016ce8d7e1b60e9414eeae8055204e2e409ef739cda9cd036f0dd7cc1433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1877,4010,27904,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25168189$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nguyen, Si Van</creatorcontrib><creatorcontrib>Nakamura, Takamitsu</creatorcontrib><creatorcontrib>Kugiyama, Kiyotaka</creatorcontrib><title>High Remnant Lipoprotein Predicts Recurrent Cardiovascular Events on Statin Treatment After Acute Coronary Syndrome</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>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<0.01). The addition of high RLP-C to traditional risk factors enhanced net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI, 0.66, P=0.0003; and IDI, 0.08, P=0.0002).Conclusions:RLP-C is useful for risk assessment of secondary cardiovascular events in patients treated with statins after ACS. (Circ J 2014; 78: 2492–2500)</description><subject>Acute coronary syndrome</subject><subject>Acute Coronary Syndrome - blood</subject><subject>Acute Coronary Syndrome - drug therapy</subject><subject>Acute Coronary Syndrome - mortality</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angina, Unstable - blood</subject><subject>Angina, Unstable - etiology</subject><subject>Angina, Unstable - mortality</subject><subject>Cholesterol - blood</subject><subject>Death</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage</subject><subject>Lipoproteins - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Remnant lipoprotein</subject><subject>Risk Factors</subject><subject>Statin</subject><subject>Triglycerides - blood</subject><issn>1346-9843</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkM1P3DAQxS3UCijlzqnysZfQcewkznEVUShaqVWhZ8s4E_AqibdjB4n_vl52Cwd_aOb3nsePsQsBl6Ks5DfnyW0uu9tCqAKkhiN2KqRqCqVL-PB6r4tWK3nCPsW4AShbqNpjdlJWotZCt6cs3vjHJ_4bp9nOia_9NmwpJPQz_0XYe5dibrqFCHO7s9T78GyjW0ZL_Oo5FyMPM79LNmXJPaFN045cDQmJr9ySkHeBwmzphd-9zD2FCT-zj4MdI54fzjP25_vVfXdTrH9e_-hW68LVjU6FxMGWIGqHum9QPNSArRIK0aKGqipBYYkKWhwa2bre5gWyHqDvG-eEkvKMfd375i_9XTAmM_nocBztjGGJRlR1LaCtQGQU9qijECPhYLbkpzy0EWB2UZvXqE13a4Qyu6iz5MvBfXmYsH8T_M82A9d7YBOTfcQ3wFLybsSDY6N3T-T93fqdeLJkcJb_AIq4lvE</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Nguyen, Si Van</creator><creator>Nakamura, Takamitsu</creator><creator>Kugiyama, Kiyotaka</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2014</creationdate><title>High Remnant Lipoprotein Predicts Recurrent Cardiovascular Events on Statin Treatment After Acute Coronary Syndrome</title><author>Nguyen, Si Van ; Nakamura, Takamitsu ; Kugiyama, Kiyotaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c678t-3efa2016ce8d7e1b60e9414eeae8055204e2e409ef739cda9cd036f0dd7cc1433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute coronary syndrome</topic><topic>Acute Coronary Syndrome - blood</topic><topic>Acute Coronary Syndrome - drug therapy</topic><topic>Acute Coronary Syndrome - mortality</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angina, Unstable - blood</topic><topic>Angina, Unstable - etiology</topic><topic>Angina, Unstable - mortality</topic><topic>Cholesterol - blood</topic><topic>Death</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage</topic><topic>Lipoproteins - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Remnant lipoprotein</topic><topic>Risk Factors</topic><topic>Statin</topic><topic>Triglycerides - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nguyen, Si Van</creatorcontrib><creatorcontrib>Nakamura, Takamitsu</creatorcontrib><creatorcontrib>Kugiyama, Kiyotaka</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nguyen, Si Van</au><au>Nakamura, Takamitsu</au><au>Kugiyama, Kiyotaka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High Remnant Lipoprotein Predicts Recurrent Cardiovascular Events on Statin Treatment After Acute Coronary Syndrome</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2014</date><risdate>2014</risdate><volume>78</volume><issue>10</issue><spage>2492</spage><epage>2500</epage><pages>2492-2500</pages><issn>1346-9843</issn><eissn>1347-4820</eissn><abstract>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<0.01). The addition of high RLP-C to traditional risk factors enhanced net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI, 0.66, P=0.0003; and IDI, 0.08, P=0.0002).Conclusions:RLP-C is useful for risk assessment of secondary cardiovascular events in patients treated with statins after ACS. (Circ J 2014; 78: 2492–2500)</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>25168189</pmid><doi>10.1253/circj.CJ-14-0380</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese |
| 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 |
| title | High Remnant Lipoprotein Predicts Recurrent Cardiovascular Events on Statin Treatment After Acute Coronary Syndrome |
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