Determinants of Achieved LDL Cholesterol and “Non-HDL” Cholesterol in the Management of Dyslipidemias

Packard, Chris J.

doi:10.1007/s11886-018-1003-x

Cited by 13 publications

(9 citation statements)

References 69 publications

(82 reference statements)

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“…28 Statins cause substantial falls in LDL and a relatively modest decrease in TGLs, including VLDL and RLP. 29,30 Our previous in vitro studies showed that RLP induced expression of endothelial proatherogenic molecules and endothelial vasomotor dysfunction to a several-fold greater extent compared with LDL or other TGLs. 31,32 As RLP had greater atherogenicity than other TGLs, RLP-C levels remained a predictor of CVEs despite the reduction in RLP-C levels on statin treatment.…”

Section: Discussionmentioning

confidence: 99%

Remnant Lipoproteins Are Residual Risk Factor for Future Cardiovascular Events in Patients With Stable Coronary Artery Disease and On-Statin Low-Density Lipoprotein Cholesterol Levels <70 mg/dL

Fujihara

Nakamura

Horikoshi

et al. 2019

Circ J

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Background: This study examined the predictive value of remnant lipoprotein levels for cardiovascular events (CVEs) in patients with stable coronary artery disease (CAD) and low-density lipoprotein cholesterol (LDL-C) levels <70 mg/dL on statin treatment. Methods and Results: Serum levels of remnant lipoproteins (remnant-like lipoprotein particles cholesterol: RLP-C) were measured by an immunoseparation method in 247 consecutive patients with CAD who had on-statin LDL-C levels <70 mg/dL. All the patients were followed prospectively for a period of ≤60 months or until the occurrence of the primary composite endpoint of cardiac death, nonfatal myocardial infarction, unstable angina requiring coronary revascularization, worsening heart failure, peripheral artery disease, aortic event, and ischemic stroke. During a mean follow-up period of 38 months, 33 CVEs occurred. Kaplan-Meier analysis demonstrated that higher RLP-C levels (≥3.9 mg/dL, determined by ROC curve) resulted in a significantly higher probability for the primary endpoint than did lower RLP-C levels (<3.9 mg/dL) (P<0.01 by log-rank test). Stepwise multivariate Cox proportional hazard analysis showed that RLP-C was a significant predictor of the primary endpoint after adjustment for known risk factors and lipid variables including triglycerides, and total apolipoprotein B (hazard ratio 1.62, 95% confidence interval 1.26-2.07, P<0.01). Conclusions: RLP-C levels are a residual risk factor for future CVEs in patients with CAD and on-statin LDL-C <70 mg/dL.

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Section: Discussionmentioning

confidence: 99%

Remnant Lipoproteins Are Residual Risk Factor for Future Cardiovascular Events in Patients With Stable Coronary Artery Disease and On-Statin Low-Density Lipoprotein Cholesterol Levels <70 mg/dL

Fujihara

Nakamura

Horikoshi

et al. 2019

Circ J

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“…We speculated that the significant increases in LysoPC and LysoPE intensities in group D observed in this study may be related to enhanced PLA2 activity. [39] Studies have shown that quercetin can inhibit PLA2 activity. [40,41] In this study, the changes in the activity of PLA2 and the intensities of LysoPC, LysoPE indicate that cadmium affected lipid metabolism and high doses of quercetin exert a protective effect against cadmium-induced lipid metabolism disorders.…”

Section: The First Pathway Involves the Effect Of Quercetin On Cadmmentioning

confidence: 99%

Serum metabonomics analysis of quercetin against the toxicity induced by cadmium in rats

Jia

Guan

Zhang

et al. 2020

J Biochem & Molecular Tox

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This study aimed to investigate the protective effect of quercetin against the toxicity induced by chronic exposure to low levels of cadmium in rats by an ultra performance liquid chromatography mass spectrometer. Rats were randomly divided into six groups as follows: control group (C), low dose of quercetin group (Q1: 10 mg/kg·bw), high dose of quercetin group (Q2: 50 mg/kg·bw), cadmium chloride group (D), low dose of quercetin plus cadmium chloride group (DQ1), and high dose of quercetin plus cadmium chloride group (DQ2). Cadmium chloride (CdCl2) was administered to rats by drinking water ad libitum in a concentration of 40 mg/L. The final amount of CdCl2 ingested was estimated from the water consumption data to be 4.85, 4.91, and 4.89 mg/kg·bw/day, for D, DQ1, and DQ2 groups, respectively. After a 12‐week treatment, the serum samples of rats were collected for metabonomics analysis. Ten potential biomarkers were identified for which intensities were significantly increased or reduced as a result of the treatment. These metabolites included isorhamnetin 4′‐O‐glucuronide, 3‐indolepropionic acid, tetracosahexaenoic acid, lysophosphatidylcholine (LysoPC) (20:5), lysoPC (18:3), lysophosphatidylethanolamine (LysoPE) (20:5/0:0), bicyclo‐prostaglandin E2, sulpholithocholylglycine, lithocholyltaurine, and glycocholic acid. Results indicated that quercetin exerted a protective effect against cadmium‐induced toxicity by regulating lipid and amino acid metabolism, enhancing the antioxidant defense system and protecting liver and kidney function.

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“…In this context, while regarding LDL-C as the major target, the exploration of residual risk factors, such as RLP-C, can also provide complementary therapeutic strategies for reducing cardiovascular risk. Previous reports showed that lipid-lowering agents, such as brates, ezetimibe, and statins, as well as diet adaptation, proper aerobic exercise, and obesity reduction, may effectively decrease RLP-C levels to varying degrees [26,43,44], thus enabling RLP-C as a therapeutic target. Clinical trials of non-statin, lipid-lowering treatments have shown signi cant bene t in reducing residual risk, but none have speci cally targeted RLP-C. Studies have demonstrated that omega-3 fatty acid derivatives [45] and antisense oligonucleotide to apolipoprotein C-III [46] have the potential to reduce TRLs signi cantly and provide useful tools for answering this question.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Estimated Remnant-like Particle Cholesterol in Patients with Differing Glycometabolic Status: an Observational Cohort Study from China

Zhao

Zhang

Cheng

et al. 2020

Preprint

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Background: It is uncertain whether estimated remnant-like particle cholesterol (RLP-C) could predict residual risk in patients with different glycometabolic status. This study aimed to evaluate the relationship between estimated RLP-C and adverse prognosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) treated with percutaneous coronary intervention (PCI) and to identify the potential impact of glycometabolism on the predictive value of estimated RLP-C.Methods: The study assessed 2419 participants with NSTE-ACS undergoing PCI at Beijing Anzhen Hospital from January to December 2015. Estimated RLP-C was calculated as follows: total cholesterol (TC) minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The adverse events included all-cause death, non-fatal myocardial infarction (MI), and ischemia-driven revascularization.Results: Estimated RLP-C was prominently associated with adverse prognosis in the total population [hazard ratio (HR) 1.291 per 1-SD increase, 95% confidence interval (CI) 1.119-1.490, P < 0.001], independent of confounding risk factors. However, subgroup analysis showed that increasing estimated RLP-C was related to a higher risk of adverse events in the diabetic population only [HR 1.385 per 1-SD increase, 95% CI 1.183-1.620, P < 0.001]. Estimated RLP-C failed to be a significant determinant of adverse prognosis in non-diabetic and pre-diabetic subgroups. The addition of estimated RLP-C to a baseline model including traditional risk factors enhanced the predictive performance both in total and diabetic populations.Conclusions: High estimated RLP-C levels are a significant predictor for recurrent adverse events in patients with diabetes and NSTE-ACS treated with PCI.

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Determinants of Achieved LDL Cholesterol and “Non-HDL” Cholesterol in the Management of Dyslipidemias

Cited by 13 publications

References 69 publications

Remnant Lipoproteins Are Residual Risk Factor for Future Cardiovascular Events in Patients With Stable Coronary Artery Disease and On-Statin Low-Density Lipoprotein Cholesterol Levels <70 mg/dL

Remnant Lipoproteins Are Residual Risk Factor for Future Cardiovascular Events in Patients With Stable Coronary Artery Disease and On-Statin Low-Density Lipoprotein Cholesterol Levels <70 mg/dL

Serum metabonomics analysis of quercetin against the toxicity induced by cadmium in rats

Prognostic Impact of Estimated Remnant-like Particle Cholesterol in Patients with Differing Glycometabolic Status: an Observational Cohort Study from China

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