Low-Density Lipoprotein Cholesterol, Non–High-Density Lipoprotein Cholesterol, Triglycerides, and Apolipoprotein B and Cardiovascular Risk in Patients With Manifest Arterial Disease

• Published in: The American journal of cardiology Vol. 118; no. 6; pp. 804 - 810
• Main Authors: van den Berg, M. Johanneke, van der Graaf, Yolanda, de Borst, Gert Jan, Kappelle, L. Jaap, Nathoe, Hendrik M., Visseren, Frank L.J., van Petersen, R., van Dinther, B.G.F., Algra, A., Grobbee, D.E., Rutten, G.E.H.M., Leiner, T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.09.2016; Elsevier Limited
• Subjects: Abdomen; Aged; Alcohol; Aneurysms; Angina pectoris; Angioplasty; Apolipoprotein B-100 - blood; Apolipoproteins; Atherosclerosis; Body mass index; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Cerebrovascular Disorders - blood; Cerebrovascular Disorders - epidemiology; Cholesterol; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cohort Studies; Confidence intervals; Coronary Artery Disease - blood; Coronary Artery Disease - epidemiology; Coronary vessels; Diabetes; Female; Health risk assessment; Heart attacks; Humans; Hypertension; Lipids; Low density lipoprotein; Male; Middle Aged; Mortality; Myocardial Infarction - blood; Myocardial Infarction - epidemiology; Netherlands - epidemiology; Patients; Peripheral Arterial Disease - blood; Peripheral Arterial Disease - epidemiology; Population; Prognosis; Proportional Hazards Models; Prospective Studies; Standard deviation; Stroke; Stroke - blood; Stroke - epidemiology; Studies; Triglycerides; Triglycerides - blood
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.06.048

Low-density lipoprotein cholesterol (LDL-C) only partly represents the atherogenic lipid burden, and a growing body of evidence suggests that non–high-density lipoprotein cholesterol (non-HDL-C), triglycerides, and apolipoprotein B (apoB) are more accurate in estimating lipid-related cardiovascular disease risk. Our objective was to compare the relation among LDL-C, non-HDL-C, triglycerides, and apoB and the occurrence of future vascular events and mortality in patients with manifest arterial disease. This is a prospective cohort study of 7,216 patients with clinically manifest arterial disease in the Secondary Manifestations of Arterial Disease Study. Cox proportional hazard models were used to quantify the risk of major cardiovascular events (MACE; i.e., stroke, myocardial infarction, and vascular mortality) and all-cause mortality. Interaction was tested for type of vascular disease at inclusion. MACE occurred in 1,185 subjects during a median follow-up of 6.5 years (interquartile range 3.4 to 9.9 years). Adjusted hazard ratios (HRs) of MACE per 1 SD higher were for LDL-C (HR 1.15, 95% confidence interval [CI] 1.09 to 1.22), for non-HDL-C (HR 1.17, 95% CI 1.11 to 1.23), for log(triglycerides) (HR 1.12, 95% CI 1.06 to 1.19), and for apoB HR (1.12, 95% CI 0.99 to 1.28). The relation among LDL-C, non-HDL-C, and cardiovascular events was comparable in patients with cerebrovascular disease, coronary artery disease, or polyvascular disease and absent in those with aneurysm of abdominal aorta or peripheral artery disease. In conclusion, in patients with a history of cerebrovascular, coronary artery, or polyvascular disease, but not aneurysm of abdominal aorta or peripheral artery disease, higher levels of LDL-C and non-HDL-C are related to increased risk of future MACE and of comparable magnitude.