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Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation

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Storey, BC, Staplin, N, Haynes, R, Reith, C, Emberson, J, Herrington, WG, Wheeler, DC, Walker, R, Fellström, B, Wanner, C, Landray, MJ, Baigent, C, SHARP Collaborative Group (Bo Feldt-Rasmussen, members) & Feldt-Rasmussen, BF 2018, 'Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation' Kidney International, bind 93, nr. 4, s. 1000-1007. https://doi.org/10.1016/j.kint.2017.09.011

APA

CBE

Storey BC, Staplin N, Haynes R, Reith C, Emberson J, Herrington WG, Wheeler DC, Walker R, Fellström B, Wanner C, Landray MJ, Baigent C, SHARP Collaborative Group (Bo Feldt-Rasmussen, members), Feldt-Rasmussen BF. 2018. Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation. Kidney International. 93(4):1000-1007. https://doi.org/10.1016/j.kint.2017.09.011

MLA

Vancouver

Author

Storey, Benjamin C ; Staplin, Natalie ; Haynes, Richard ; Reith, Christina ; Emberson, Jonathan ; Herrington, William G ; Wheeler, David C ; Walker, Robert ; Fellström, Bengt ; Wanner, Christoph ; Landray, Martin J ; Baigent, Colin ; SHARP Collaborative Group (Bo Feldt-Rasmussen, members) ; Feldt-Rasmussen, Bo Friis. / Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation. I: Kidney International. 2018 ; Bind 93, Nr. 4. s. 1000-1007.

Bibtex

@article{750856876c52483b9c1edafba94bf916,
title = "Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation",
abstract = "Markers of inflammation, including plasma C-reactive protein (CRP), are associated with an increased risk of cardiovascular disease, and it has been suggested that this association is causal. However, the relationship between inflammation and cardiovascular disease has not been extensively studied in patients with chronic kidney disease. To evaluate this, we used data from the Study of Heart and Renal Protection (SHARP) to assess associations between circulating CRP and LDL cholesterol levels and the risk of vascular and non-vascular outcomes. Major vascular events were defined as nonfatal myocardial infarction, cardiac death, stroke or arterial revascularization, with an expanded outcome of vascular events of any type. Higher baseline CRP was associated with an increased risk of major vascular events (hazard ratio per 3x increase 1.28; 95{\%} confidence interval 1.19-1.38). Higher baseline LDL cholesterol was also associated with an increased risk of major vascular events (hazard ratio per 0.6 mmol/L higher LDL cholesterol; 1.14, 1.06-1.22). Higher baseline CRP was associated with an increased risk of a range of non-vascular events (1.16, 1.12-1.21), but there was a weak inverse association between baseline LDL cholesterol and non-vascular events (0.96, 0.92-0.99). The efficacy of lowering LDL cholesterol with simvastatin/ezetimibe on major vascular events, in the randomized comparison, was similar irrespective of CRP concentration at baseline. Thus, decisions to offer statin-based therapy to patients with chronic kidney disease should continue to be guided by their absolute risk of atherosclerotic events. Estimation of such risk may include plasma biomarkers of inflammation, but there is no evidence that the relative beneficial effects of reducing LDL cholesterol depends on plasma CRP concentration.",
keywords = "Journal Article",
author = "Storey, {Benjamin C} and Natalie Staplin and Richard Haynes and Christina Reith and Jonathan Emberson and Herrington, {William G} and Wheeler, {David C} and Robert Walker and Bengt Fellstr{\"o}m and Christoph Wanner and Landray, {Martin J} and Colin Baigent and {SHARP Collaborative Group (Bo Feldt-Rasmussen, members)} and Feldt-Rasmussen, {Bo Friis}",
note = "Copyright {\circledC} 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.",
year = "2018",
doi = "10.1016/j.kint.2017.09.011",
language = "English",
volume = "93",
pages = "1000--1007",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "4",

}

RIS

TY - JOUR

T1 - Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation

AU - Storey, Benjamin C

AU - Staplin, Natalie

AU - Haynes, Richard

AU - Reith, Christina

AU - Emberson, Jonathan

AU - Herrington, William G

AU - Wheeler, David C

AU - Walker, Robert

AU - Fellström, Bengt

AU - Wanner, Christoph

AU - Landray, Martin J

AU - Baigent, Colin

AU - SHARP Collaborative Group (Bo Feldt-Rasmussen, members)

A2 - Feldt-Rasmussen, Bo Friis

N1 - Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

PY - 2018

Y1 - 2018

N2 - Markers of inflammation, including plasma C-reactive protein (CRP), are associated with an increased risk of cardiovascular disease, and it has been suggested that this association is causal. However, the relationship between inflammation and cardiovascular disease has not been extensively studied in patients with chronic kidney disease. To evaluate this, we used data from the Study of Heart and Renal Protection (SHARP) to assess associations between circulating CRP and LDL cholesterol levels and the risk of vascular and non-vascular outcomes. Major vascular events were defined as nonfatal myocardial infarction, cardiac death, stroke or arterial revascularization, with an expanded outcome of vascular events of any type. Higher baseline CRP was associated with an increased risk of major vascular events (hazard ratio per 3x increase 1.28; 95% confidence interval 1.19-1.38). Higher baseline LDL cholesterol was also associated with an increased risk of major vascular events (hazard ratio per 0.6 mmol/L higher LDL cholesterol; 1.14, 1.06-1.22). Higher baseline CRP was associated with an increased risk of a range of non-vascular events (1.16, 1.12-1.21), but there was a weak inverse association between baseline LDL cholesterol and non-vascular events (0.96, 0.92-0.99). The efficacy of lowering LDL cholesterol with simvastatin/ezetimibe on major vascular events, in the randomized comparison, was similar irrespective of CRP concentration at baseline. Thus, decisions to offer statin-based therapy to patients with chronic kidney disease should continue to be guided by their absolute risk of atherosclerotic events. Estimation of such risk may include plasma biomarkers of inflammation, but there is no evidence that the relative beneficial effects of reducing LDL cholesterol depends on plasma CRP concentration.

AB - Markers of inflammation, including plasma C-reactive protein (CRP), are associated with an increased risk of cardiovascular disease, and it has been suggested that this association is causal. However, the relationship between inflammation and cardiovascular disease has not been extensively studied in patients with chronic kidney disease. To evaluate this, we used data from the Study of Heart and Renal Protection (SHARP) to assess associations between circulating CRP and LDL cholesterol levels and the risk of vascular and non-vascular outcomes. Major vascular events were defined as nonfatal myocardial infarction, cardiac death, stroke or arterial revascularization, with an expanded outcome of vascular events of any type. Higher baseline CRP was associated with an increased risk of major vascular events (hazard ratio per 3x increase 1.28; 95% confidence interval 1.19-1.38). Higher baseline LDL cholesterol was also associated with an increased risk of major vascular events (hazard ratio per 0.6 mmol/L higher LDL cholesterol; 1.14, 1.06-1.22). Higher baseline CRP was associated with an increased risk of a range of non-vascular events (1.16, 1.12-1.21), but there was a weak inverse association between baseline LDL cholesterol and non-vascular events (0.96, 0.92-0.99). The efficacy of lowering LDL cholesterol with simvastatin/ezetimibe on major vascular events, in the randomized comparison, was similar irrespective of CRP concentration at baseline. Thus, decisions to offer statin-based therapy to patients with chronic kidney disease should continue to be guided by their absolute risk of atherosclerotic events. Estimation of such risk may include plasma biomarkers of inflammation, but there is no evidence that the relative beneficial effects of reducing LDL cholesterol depends on plasma CRP concentration.

KW - Journal Article

U2 - 10.1016/j.kint.2017.09.011

DO - 10.1016/j.kint.2017.09.011

M3 - Journal article

VL - 93

SP - 1000

EP - 1007

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 4

ER -

ID: 52424295