Residual Risk of Atherosclerotic Cardiovascular Events in Relation to Reductions in Very‐Low‐Density Lipoproteins

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Paul M Ridker¹  Paulo Harada²  Samia Mora²  Akintunde O. Akinkuolie²  Patrick R. Lawler³  Daniel I. Chasman⁴  Robert J. Glynn⁴ 

[1] Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;Center for Lipid Metabolomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada;Preventive Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;

关键词: arteriosclerosis;    lipids;    lipoproteins;    metabolomics;    personalized medicine;    primary prevention;   

DOI  :  10.1161/JAHA.117.007402

来源: DOAJ

【 摘 要 】

BackgroundIt is uncertain whether pharmacological reductions in very‐low‐density lipoproteins (VLDLs), and their component triglyceride and cholesterol could reduce residual risk of atherosclerotic cardiovascular disease (ASCVD) events among individuals in whom low‐density lipoprotein cholesterol (LDL‐C) has been adequately lowered. We examined whether individuals with greater on‐statin reductions in VLDL‐related measures—beyond reductions in LDL‐C—were at further reduced risk of ASCVD. Methods and ResultsIn 9423 participants in the JUPITER (Justification for the Use of Statins in Prevention) trial (NCT00239681), at baseline and on statin we measured standard lipids, 400‐MHz proton nuclear magnetic resonance spectroscopy‐measured VLDL particle subclasses (small, medium, and large VLDL lipoprotein particle concentration), and total VLDL cholesterol mass. Compared with individuals allocated to placebo, we examined risk of incident ASCVD (N=211) among statin‐allocated participants who achieved minimal (

【 授权许可】

Unknown