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Lipids and Lipoproteins and Risk of Different Vascular Events in the MRC/BHF Heart Protection Study

Published on May 22, 2012in Circulation 18.88
· DOI :10.1161/CIRCULATIONAHA.111.073684
S Parish55
Estimated H-index: 55
(Clinical Trial Service Unit),
Alison Offer9
Estimated H-index: 9
(Clinical Trial Service Unit)
+ 5 AuthorsRory Collins131
Estimated H-index: 131
(Clinical Trial Service Unit)
Abstract
Background—Low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol are established risk factors for vascular disease, but lipoprotein particle concentrations may be stronger determinants of risk. Methods and Results—Associations between vascular events and baseline concentrations of cholesterol fractions, apolipoproteins B and A1, and lipoprotein particles assessed by nuclear magnetic resonance were considered in the Heart Protection Study randomized trial of simvastatin versus placebo (>5000 vascular events during 5.3 years of follow-up among 20 000 participants). Major occlusive coronary events were equally strongly associated with the cholesterol- and particle-based total LDL measures; adjusted hazard ratios per 1-SD-higher level were 1.25 (95% confidence interval [CI], 1.16–1.34) for LDL cholesterol, 1.22 (95% CI, 1.14–1.32) for non–HDL cholesterol, 1.23 (95% CI, 1.15–1.33) for apolipoprotein B, and 1.25 (95% CI, 1.16–1.35) for LDL particle number. Given the total LDL ...
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  • Citations (130)
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References39
Newest
Published on Apr 1, 2011in Nature Reviews Cardiology 15.16
Benoit J. Arsenault34
Estimated H-index: 34
(University of Amsterdam),
S. Matthijs Boekholdt56
Estimated H-index: 56
(University of Amsterdam),
John J. P. Kastelein119
Estimated H-index: 119
(University of Amsterdam)
The benefits of lowering LDL-cholesterol levels to prevent clinical events are well-recognized. However, other parameters of the lipoprotein–lipid profile are likely to contribute to cardiovascular risk and should be used in addition to the traditional lipid profile for improved assessment of cardiovascular risk. The authors of this Review discuss alternative and emerging lipid parameters associated with cardiovascular disease that could identify patients at high risk and those who will benefit ...
119 Citations Source Cite
Published on Mar 1, 2011in Clinical Chemistry 8.64
Robert S. Rosenson58
Estimated H-index: 58
(Icahn School of Medicine at Mount Sinai),
H. Bryan Brewer67
Estimated H-index: 67
(Memorial Hospital of South Bend)
+ 7 AuthorsErnst J. Schaefer117
Estimated H-index: 117
(Tufts University)
BACKGROUND: A growing body of evidence from epidemiological data, animal studies, and clinical trials supports HDL as the next target to reduce residual cardiovascular risk in statin-treated, high-risk patients. For more than 3 decades, HDL cholesterol has been employed as the principal clinical measure of HDL and cardiovascular risk associated with low HDL-cholesterol concentrations. The physicochemical and functional heterogeneity of HDL present important challenges to investigators in the car...
278 Citations Source Cite
Published on Mar 1, 2011in Journal of Clinical Lipidology 3.58
James D. Otvos51
Estimated H-index: 51
,
Samia Mora46
Estimated H-index: 46
(Brigham and Women's Hospital)
+ 3 AuthorsDavid C. Goff75
Estimated H-index: 75
(Wake Forest University)
Background The amount of cholesterol per low-density lipoprotein (LDL) particle is variable and related in part to particle size, with smaller particles carrying less cholesterol. This variability causes concentrations of LDL cholesterol (LDL-C) and LDL particles (LDL-P) to be discordant in many individuals. Methods LDL-P measured by nuclear magnetic resonance spectroscopy, calculated LDL-C, and carotid intima-media thickness (IMT) were assessed at baseline in the Multi-Ethnic Study of Atheroscl...
194 Citations Source Cite
Published on Feb 5, 2011in The Lancet 53.25
Jonathan Emberson45
Estimated H-index: 45
,
D H Bennett15
Estimated H-index: 15
+ 4 AuthorsRory Collins131
Estimated H-index: 131
112 Citations Source Cite
Published on Dec 1, 2010in Biochimica et Biophysica Acta 3.44
Gordon A. Francis34
Estimated H-index: 34
Plasma high-density lipoprotein cholesterol (HDL-C) levels are inversely associated with coronary artery disease risk in large epidemiologic studies. This rule, however, has many exceptions in individual patients, and evidence suggests that other facets of high-density lipoprotein particle biology not captured by measuring HDL-C levels are responsible for HDL's effects in vivo. This article reviews the evidence for the protective nature of HDL, current evidence from animal and human studies rega...
49 Citations Source Cite
Published on Nov 13, 2010in The Lancet 53.25
Colin Baigent60
Estimated H-index: 60
,
Lisa Blackwell17
Estimated H-index: 17
+ 8 AuthorsRory Collins131
Estimated H-index: 131
BackgroundLowering of LDL cholesterol with standard statin regimens reduces the risk of occlusive vascular events in a wide range of individuals. We aimed to assess the safety and efficacy of more ...
2,890 Citations Source Cite
Published on Nov 11, 2009in JAMA 47.66
Emanuele Di Angelantonio54
Estimated H-index: 54
,
Nadeem Sarwar29
Estimated H-index: 29
+ 10 AuthorsJohn Danesh101
Estimated H-index: 101
CONTEXT: Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified. OBJECTIVE: To assess major lipids and apolipoproteins in vascular risk. DESIGN, SETTING, AND PARTICIPANTS: Individual records were supplied on 302,430 people without initial vascular disease from 68 long-term prospective studies, mostly in Europe and North America. During 2.79 million person-years of follow-up, there were 8857 nonfatal myocardial infarctions, 3928 corona...
1,426 Citations Source Cite
Published on Nov 1, 2009in Journal of the American College of Cardiology 16.83
JohnGFCleland112
Estimated H-index: 112
(University of Hull),
John J.V. McMurray146
Estimated H-index: 146
(British Heart Foundation)
+ 11 AuthorsNaresh Ranjith5
Estimated H-index: 5
Objectives We investigated whether plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of cardiac dysfunction and prognosis measured in CORONA (Controlled Rosuvastatin Multinational Trial in Heart Failure), could be used to identify the severity of heart failure at which statins become ineffective. Background Statins reduce cardiovascular morbidity and mortality in many patients with ischemic heart disease but not, overall, those with heart failure. There must be a transiti...
160 Citations Source Cite
Published on Sep 1, 2009in European Heart Journal 23.43
S Parish55
Estimated H-index: 55
(Clinical Trial Service Unit),
Richard Peto161
Estimated H-index: 161
(Clinical Trial Service Unit)
+ 8 AuthorsPeter Sleight92
Estimated H-index: 92
(Clinical Trial Service Unit)
Aims Plasma levels of apolipoprotein B (apoB), the main surface protein on LDL particles, and LDL-C, the amount of cholesterol in those particles, are closely correlated and, considered separately, are positive risk factors. Plasma levels of apolipoprotein A1, the main surface protein on HDL particles, and HDL-C, the amount of cholesterol in those particles, are also closely correlated with each other and, considered separately, are negative risk factors. The interdependence of these four risk f...
69 Citations Source Cite
Cited By130
Newest
Published on May 13, 2019in European Journal of Preventive Cardiology 4.54
Marc Allard-Ratick2
Estimated H-index: 2
(Emory University),
Bryan Kindya1
Estimated H-index: 1
(Emory University)
+ 4 AuthorsLaurence Sperling29
Estimated H-index: 29
(Emory University)
The measurement of high-density lipoprotein cholesterol is highly utilized by clinicians to help predict cardiovascular risk, but this measure is not causally associated with atherosclerotic cardiovascular disease events. The use of Mendelian randomization studies has led to a change in investigative attention from the high-density lipoprotein cholesterol concentration to its physiological functions. High-density lipoprotein plays key roles in important pathways related to the development of ath...
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Published on Jan 1, 2019in Critical Reviews in Oncology Hematology 4.50
V.G. Pluimakers , M. van Waas (Boston Children's Hospital)+ 1 AuthorsMarry M. van den Heuvel-Eibrink52
Estimated H-index: 52
Abstract Over the past decades, survival rates of childhood cancer have increased considerably from 5 to 30% in the early seventies to current rates exceeding 80%. This is due to the development of effective chemotherapy, surgery, radiotherapy and stem cell transplantation, combined with an optimized stratification of therapy and better supportive care regimens. As a consequence, active surveillance strategies of late sequelae have been developed to improve the quality of survival. Several epide...
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Published on Dec 1, 2018in Lipids in Health and Disease 2.66
YuJing Wu , Zhijuan Fan3
Estimated H-index: 3
+ 2 AuthorsShuye Liu3
Estimated H-index: 3
Background Trails aimed at raising high density lipoprotein(HDL) cholesterol concentration failed to make better cardiovascular outcomes. HDL particles may be better biomarkers reflecting properties of HDL. This meta-analysis was conducted to evaluate the relation between blood HDL particles level and cardiovascular events.
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Published on Nov 1, 2018in Revista Espanola De Cardiologia 5.17
Gabriel Vázquez-Oliva3
Estimated H-index: 3
(University of Girona),
Alberto Zamora10
Estimated H-index: 10
(University of Girona)
+ 7 AuthorsJaume Marrugat67
Estimated H-index: 67
(Grupo México)
Abstract Introduction and objectives New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function. Methods A case-cohort study was designed. From an initial cohort of 5404 individua...
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Published on Nov 1, 2018in Revista Espanola De Cardiologia 5.17
Gabriel Vázquez-Oliva3
Estimated H-index: 3
(University of Girona),
Alberto Zamora10
Estimated H-index: 10
(University of Girona)
+ 7 AuthorsJaume Marrugat67
Estimated H-index: 67
(Grupo México)
espanolIntroduccion y objetivos La inclusion de biomarcadores en las funciones de riesgo clasicas puede mejorar la estimacion del riesgo. Los objetivos del estudio son determinar la asociacion entre las concentraciones de apolipoproteina A1 (apoA1), apolipoproteina B (apoB), albumina y 25–OH-vitamina D circulantes y la incidencia de eventos coronarios y analizar si estos biomarcadores mejoran la capacidad predictiva de la funcion REGICOR. Metodos Estudio de cohorte de casos. De una cohorte inici...
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Published on Aug 1, 2018in International Journal of Cardiology 4.03
G. Pichler4
Estimated H-index: 4
(University of Valencia),
Núria Amigó6
Estimated H-index: 6
(Rovira i Virgili University)
+ 9 AuthorsF.J. Chaves24
Estimated H-index: 24
(Instituto de Salud Carlos III)
Abstract Background The association of low-density lipoprotein (LDL) particle composition with cardiovascular risk has not been explored before. The aim was to evaluate the relationship between baseline LDL particle size and composition (proportions of large, medium and small LDL particles over their sum expressed as small-LDL %, medium-LDL % and large-LDL %) and incident cardiovascular disease in a population-based study. Methods Direct measurement of LDL particles was performed using a two-dim...
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Published on Jul 1, 2018in Journal of Clinical Lipidology 3.58
Katya B. Rubinow10
Estimated H-index: 10
(University of Washington),
Tomas Vaisar28
Estimated H-index: 28
(University of Washington)
+ 2 AuthorsStephanie T. Page31
Estimated H-index: 31
(University of Washington)
Background Exogenous testosterone decreases serum concentrations of high-density lipoprotein cholesterol (HDL-C) in men, but whether this alters cardiovascular risk is uncertain. Objective To investigate the effects of testosterone and estradiol on HDL particle concentration (HDL-Pima) and metrics of HDL function. Methods We enrolled 53 healthy men, 19 to 55 years of age, in a double-blinded, placebo-controlled, randomized trial. Subjects were rendered medically castrate using the GnRH receptor ...
1 Citations Source Cite
Published on Jul 1, 2018in The Lancet Diabetes & Endocrinology 19.31
L Gnatiuc1
Estimated H-index: 1
,
Wg Herrington1
Estimated H-index: 1
+ 169 AuthorsJacobs1
Estimated H-index: 1
Summary Background Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. Methods In o...
15 Citations Source Cite
Published on May 27, 2018in Diseases
Christian Abendstein Kjellmo2
Estimated H-index: 2
,
Anders Hovland10
Estimated H-index: 10
,
Knut Tore Lappegård21
Estimated H-index: 21
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors reduce the risk of cardiovascular events and all-cause mortality in patients at high risk of cardiovascular disease (CVD). Due to high costs and unknown long-term adverse effects, critical evaluation of patients considered for PCSK9 inhibitors is important. It has been proposed that measuring low-density lipoprotein (LDL) subfractions, or LDL particle numbers (LDL-P), could be of value in CVD risk assessment and may identify patien...
1 Citations Source Cite