Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Atherogenic dyslipidemia and residual cardiovascular risk in statin-treated patients

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Incidence of Ischemic Stroke in Individuals With and Without Aortic Valve Stenosis: A Danish Retrospective Cohort Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Global Burden of Small Vessel Disease-Related Brain Changes on MRI Predicts Cognitive and Functional Decline

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Full-Volume Assessment of Abdominal Aortic Aneurysms by 3-D Ultrasound and Magnetic Tracking

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Vascular function in adults with cyanotic congenital heart disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. In Situ Vein Bypass Is Superior to Endovascular Treatment of Femoropopliteal Lesions in Chronic Limb-Threatening Ischemia

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Carotid atherosclerosis markers and adverse cardiovascular events

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  • Gaia Sirimarco
  • Julien Labreuche
  • Eric Bruckert
  • Larry B Goldstein
  • Kim M Fox
  • Peter M Rothwell
  • Pierre Amarenco
  • PERFORM and SPARCL Investigators and Committees
  • Henrik Hegaard Sillesen
Vis graf over relationer

BACKGROUND AND PURPOSE: Treatment with statins reduces the rate of cardiovascular events in high-risk patients, but residual risk persists. At least part of that risk may be attributable to atherogenic dyslipidemia characterized by low high-density lipoprotein cholesterol (≤40 mg/dL) and high triglycerides (triglycerides≥150 mg/dL).

METHODS: We studied subjects with stroke or transient ischemic attack in the Prevention of Cerebrovascular and Cardiovascular Events of Ischemic Origin With Terutroban in Patients With a History of Ischemic Stroke or Transient Ischemic Attack (PERFORM; n=19,100) and Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL; n=4731) trials who were treated with a statin and who had high-density lipoprotein cholesterol and triglycerides measurements 3 months after randomization (n=10,498 and 2900, respectively). The primary outcome measure for this exploratory analysis was the occurrence of major cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death). We also performed a time-varying analysis to account for all available high-density lipoprotein cholesterol and triglyceride measurements.

RESULTS: A total of 10% of subjects in PERFORM and 9% in SPARCL had atherogenic dyslipidemia after ≥3 months on start statin therapy. After a follow-up of 2.3 years (PERFORM) and 4.9 years (SPARCL), a major cardiovascular event occurred in 1123 and 485 patients in the 2 trials, respectively. The risk of major cardiovascular events was higher in subjects with versus those without atherogenic dyslipidemia in both PERFORM (hazard ratio, 1.36; 95% confidence interval, 1.14-1.63) and SPARCL (hazard ratio, 1.40; 95% confidence interval, 1.06-1.85). The association was attenuated after multivariable adjustment (hazard ratio, 1.23; 95% confidence interval, 1.03-1.48 in PERFORM and hazard ratio, 1.24; 95% confidence interval, 0.93-1.65 in SPARCL). Time-varying analysis confirmed these findings.

CONCLUSIONS: The presence of atherogenic dyslipidemia was associated with higher residual cardiovascular risk in PERFORM and SPARCL subjects with stroke or transient ischemic attack receiving statin therapy. Specific therapeutic interventions should now be trialed to address this residual risk.

OriginalsprogEngelsk
TidsskriftStroke; a journal of cerebral circulation
Vol/bind45
Udgave nummer5
Sider (fra-til)1429-36
Antal sider8
ISSN0039-2499
DOI
StatusUdgivet - maj 2014

ID: 45288777