Can remnant cholesterol (triglyceride-rich lipoproteins) reclassify estimated risk of atherosclerotic cardiovascular disease?

被引:8
|
作者
Doi, Takahito [1 ,2 ,3 ]
Nordestgaard, Borge G. [1 ,2 ,3 ]
Langsted, Anne [1 ,2 ,3 ,4 ]
机构
[1] Copenhagen Univ Hosp Herlev & Gentofte, Dept Clin Biochem, Copenhagen, Denmark
[2] Copenhagen Gen Populat Study, Copenhagen, Denmark
[3] Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark
[4] Copenhagen Univ Hosp Herlevand Gentofte, Dept Clin Biochem, Borgmester Ib Juuls Vej 73, DK-2730 Herlev, Denmark
基金
日本学术振兴会;
关键词
cardiovascular disease; dyslipidemia; guidelines; heart attack; lipids; LDL CHOLESTEROL; ARTERIAL INTIMA; HEART-DISEASE; LOW-DENSITY; IN-VIVO; PLASMA; PARTICIPANTS; INDIVIDUALS; INHIBITION;
D O I
10.1097/MED.0000000000000799
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of reviewTo summarize recent studies analyzing reclassification of estimated risk of myocardial infarction (MI) and ischemic heart disease (IHD) by inclusion of remnant cholesterol (= cholesterol content in triglyceride-rich lipoproteins) in primary and secondary prevention settings.Recent findingsFor individuals in a primary prevention setting with remnant cholesterol levels at least 95th percentile (>= 1.6 mmol/l, 61 mg/dl), 23% of MI and 21% of IHD events developed later were reclassified correctly from below to above 5% for 10-year occurrence when remnant cholesterol levels were added to models based on conventional risk factors, whereas no events were reclassified incorrectly. Overall improved reclassification of MI was also observed for remnant cholesterol levels as low as at least 50th percentile (>= 0.6 mmol/l, 25 mg/dl); however, the addition of remnant cholesterol over the entire concentration range yielded insignificant improvements of NRI for MI but slightly improved reclassification of NRI for IHD. In a secondary prevention setting, addition of remnant cholesterol over the entire concentration range to a conventional risk model improved reclassification.Elevated remnant cholesterol levels considerably improves reclassification of individuals who later develop MI and IHD, in primary as well as in secondary prevention settings.
引用
收藏
页码:128 / 135
页数:8
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