Non–High-Density Lipoprotein Cholesterol, Guideline Targets, and Population Percentiles for Secondary Prevention in 1.3 Million Adults

El‐Shazly, Mohamed; Martin, Seth S.; Blaha, Michael J.; Joshi, Parag H.; Tóth, Peter P.; McEvoy, John W.; Al-Hijji, ‪Mohammed; Kulkarni, Krishnaji; Kwiterovich, Peter O.; Blumenthal, Roger S.; Jones, Steven R.

doi:10.1016/j.jacc.2013.07.045

Cited by 59 publications

(45 citation statements)

References 16 publications

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“…There is a notable discordance between non-HDLC and LDLC levels in the US population. 29,30 A sizeable proportion of individuals with LDLC levels <70 mg/dL harbor non-HDLC levels ≥100 mg/dL, effectively reclassifying their cardiovascular risk. Previous guidelines set non-HDLC goals 30 mg/dL higher than respective LDLC goals and relegated non-HDLC as a secondary treatment target only in patients with TG levels ≥200 mg/dL.…”

Section: Non-hdl Cholesterol Triglycerides and Plaque Progression 2225mentioning

confidence: 99%

Non-HDL Cholesterol and Triglycerides

Puri

Nissen

Shao

et al. 2016

ATVB

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118

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Objectives-Non-high-density lipoprotein cholesterol (non-HDLC) levels reflect the full burden of cholesterol transported in atherogenic lipoproteins. Genetic studies suggest a causal association between elevated triglycerides (TGs)-rich lipoproteins and atherosclerosis. We evaluated associations between achieved non-HDLC and TG levels on changes in coronary atheroma volume. Approach and Results-Data were analyzed from 9 clinical trials involving 4957 patients with coronary disease undergoing serial intravascular ultrasonography to assess changes in percent atheroma volume (∆PAV) and were evaluated against on-treatment non-HDLC and TG levels. The effects of lower (<100 mg/dL) versus higher (≥100 mg/dL) achieved non-HDLC levels and lower (<200 mg/dL) versus higher (≥200 mg/dL) achieved TG levels were evaluated in populations with variable on-treatment low-density lipoprotein cholesterol (LDLC) 0) was associated with achieved TG levels >200 mg/dL, respectively. Lower on-treatment non-HDLC and TG levels associated with significant PAV regression compared with higher non-HDLC and TG levels across all levels of LDLC and C-reactive protein and irrespective of diabetic status (P<0.001 across all comparisons). ∆PAV were more strongly influenced by changes in non-HDLC (β=0.62; P<0.001) compared with changes in LDLC (β=0.51; P<0.001). Kaplan-Meier sensitivity analyses demonstrated significantly greater major adverse cardiovascular event rates in those with higher versus lower non-HDLC and TG levels, with an earlier separation of the non-HDLC compared with the LDLC curve. Conclusions-Achieved non-HDLC levels seem more closely associated with coronary atheroma progression than LDLC.Plaque progression associates with achieved TGs, but only above levels of 200 mg/dL. These observations support a more prominent role for non-HDLC (and possibly TG) lowering in combating residual cardiovascular risk. 14 Accordingly, the relationship between achieved non-HDLC and TG levels upon coronary atheroma progression rates has yet to be defined.Coronary intravascular ultrasound is a sensitive imaging tool for measuring coronary atheroma volume and continues to play an important role for evaluating the antiatherosclerotic effects of novel therapies on serial measures of coronary disease progression. 15,16 Post hoc analyses of serial intravascular ultrasound trials demonstrated significant associations between measures of disease progression and incident cardiovascular events. 17-19The present analysis aimed to define the relationship between achieved non-HDLC and TG levels with rates of coronary atheroma progression. The effects of higher versus lower non-HDLC and TG levels on plaque progression rates were specifically explored within patients stratified according to varying degrees of residual metabolic risk (defined according to achieved LDLC, C-reactive prot...

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Section: Non-hdl Cholesterol Triglycerides and Plaque Progression 2225mentioning

confidence: 99%

Non-HDL Cholesterol and Triglycerides

Puri

Nissen

Shao

et al. 2016

ATVB

Self Cite

118

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“…Because the guidelines were established using results from patients with dyslipidemia, non-HDL-C for the screening of dyslipidemia may not be valid for practical use in a general population. A recent report suggests that in apparently healthy adults, LDL-C levels of 70 mg/dL and 100 mg/dL correspond to non-HDL-C levels of 93 mg/dL and 125 mg/dL, respectively [21]. In a study from the limiting under treatment of lipids in ACS with rosuvastatin (LUNAR) trial, an LDL-C value of 74 mg/dL corresponded to a non-HDL-C value of 92 mg/dL in subjects with acute coronary syndrome who were treated with high-dose statin therapy [22].…”

Section: Discussionmentioning

confidence: 99%

Association of Non-High-Density Lipoprotein Cholesterol with Low-Density Lipoprotein Cholesterol in Korean Children and Adolescents: The Korean National Health and Nutrition Examination Surveys 2008 - 2014

Kim¹,

Choi²,

Cho³

et al. 2016

Clin Pediatr

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Background: The aim of this study was to identify the association between non-high-density lipoprotein cholesterol (non-HDL-C) and low-density-lipoprotein cholesterol (LDL-C) according to age and gender in apparently healthy Korean children and adolescents.Methods: A total of 6,255 subjects aged 10-19 years from the 2008-2014 Korean National Health and Nutrition Examination Survey were analyzed. Serum non-HDL-C, LDL-C, and their association were evaluated according to age and gender. Results:The means of the 75th percentile and 95th percentile concentrations for non-HDL-C were 117.0 mg/dL and 148.0 mg/dL in males, respectively, and 121.0 mg/dL and 151.0 mg/dL in females, respectively. The means of the 75th percentile and 95th percentile concentrations for LDL-C were 99.2 mg/dL and 125.0 mg/dL in males, respectively, and 102.8 mg/dL and 128.9 mg/dL in females, respectively. The mean age-and gender-specific difference between non-HDL-C and LDL-C was approximately 15-20 mg/dL in all age groups. The mean difference between non-HDL-C and LDL-C was 16.8 mg/dL in males and 17.0 mg/dL in females (P=0.370). In the subgroup analyses, the mean difference between non-HDL-C and LDL-C was higher in boys and girls with TG levels ≥ 150 mg/dL than in those with TG levels <150 mg/dL (39.93 mg/dL vs 14.50 mg/dL, P < 0.001 in males and 39.28 mg / dL vs 15.13 mg/dL, P<0.001 in females). Conclusions:In apparently healthy Korean children and adolescents, the mean difference between non-HDL-C and LDL-C was approximately 20 mg/dL among both genders.

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“…Choroby te są nadal główną przyczyną zgonów w USA i Europie [1,2]. Modyfikowalne czynniki ryzyka miażdżycy zostały określone.…”

Section: Wstępunclassified

Stężenie cholesterolu nie-HDL u nastolatków obciążonych klinicznymi czynnikami ryzyka miażdżycy

et al. 2014

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Non–High-Density Lipoprotein Cholesterol, Guideline Targets, and Population Percentiles for Secondary Prevention in 1.3 Million Adults

Cited by 59 publications

References 16 publications

Non-HDL Cholesterol and Triglycerides

Non-HDL Cholesterol and Triglycerides

Association of Non-High-Density Lipoprotein Cholesterol with Low-Density Lipoprotein Cholesterol in Korean Children and Adolescents: The Korean National Health and Nutrition Examination Surveys 2008 - 2014

Stężenie cholesterolu nie-HDL u nastolatków obciążonych klinicznymi czynnikami ryzyka miażdżycy

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