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1、PreventiveCardiologyLipids,Apolipoproteins,andTheirRatiosinRelationtoCardiovascularEventsWithStatinTreatmentJohnJ.P.Kastelein,MD,PhD;WimA.vanderSteeg,MD;IngarHolme,PhD;MichaelGaffney,PhD;NiloB.Cater,MD;PhilipBarter,MD,PhD;PrakashDeedwania,MD,PhD;AndersG.Olsson,MD,PhD;S.Matthi
2、jsBoekholdt,MD,PhD;DavidA.Demicco,PharmD;MichaelSzarek,MS;JohnC.LaRosa,MD;TerjeR.Pedersen,MD,PhD;ScottM.Grundy,MD,PhD;fortheTNTandIDEALStudyGroupsBackground—Low-densitylipoprotein(LDL)cholesterolistheprincipaltargetoflipid-loweringtherapy,butrecentevidencehassuggestedmoreappr
3、opriatetargets.Wecomparedtherelationshipsofon-treatmentlevelsofLDLcholesterol,non–high-densitylipoprotein(HDL)cholesterol,andapolipoproteinB,aswellasratiosoftotal/HDLcholesterol,LDL/HDLcholesterol,andapolipoproteinB/A-I,withtheoccurrenceofcardiovasculareventsinpatientsreceivi
4、ngstatintherapy.MethodsandResults—Aposthocanalysiswasperformedthatcombineddatafrom2prospective,randomizedclinicaltrialsinwhich10001(“TreatingtoNewTargets”)and8888(“IncrementalDecreaseinEndPointsthroughAggressiveLipidLowering”)patientswithestablishedcoronaryheartdiseasewereass
5、ignedtousual-doseorhigh-dosestatintreatment.InmodelswithLDLcholesterol,non-HDLcholesterolandapolipoproteinBwerepositivelyassociatedwithcardiovascularoutcome,whereasapositiverelationshipwithLDLcholesterolwaslost.Inamodelthatcontainednon-HDLcholesterolandapolipoproteinB,neither
6、wassignificantowingtocollinearity.Total/HDLcholesterolratioandtheapolipoproteinB/A-Iratioinparticularwereeachmorecloselyassociatedwithoutcomethananyoftheindividualproatherogeniclipoproteinparameters.Conclusions—Inpatientsreceivingstatintherapy,on-treatmentlevelsofnon-HDLchole
7、sterolandapolipoproteinBweremorecloselyassociatedwithcardiovascularoutcomethanlevelsofLDLcholesterol.InclusionofmeasurementsoftheDownloadedfromhttp://ahajournals.orgbyonAugust6,2018antiatherogeniclipoproteinfractionfurtherstrengthenedtherelationships.Thesedatasupporttheuseofn
8、on-HDLcholesterolorapolipoproteinBasnoveltreatmenttargetsforstatinth
