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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Levels and changes of HDL cholesterol and apolipoprotein A-I in relation to risk of cardiovascular events among statin-treated patients; a meta-analysis</title><author><name sortKey="Boekholdt, S Matthijs" sort="Boekholdt, S Matthijs" uniqKey="Boekholdt S" first="S. Matthijs" last="Boekholdt">S. Matthijs Boekholdt</name><affiliation><nlm:aff id="A1">Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Arsenault, Benoit J" sort="Arsenault, Benoit J" uniqKey="Arsenault B" first="Benoit J." last="Arsenault">Benoit J. Arsenault</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Hovingh, G Kees" sort="Hovingh, G Kees" uniqKey="Hovingh G" first="G. Kees" last="Hovingh">G. Kees Hovingh</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Mora, Samia" sort="Mora, Samia" uniqKey="Mora S" first="Samia" last="Mora">Samia Mora</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts, USA</nlm:aff></affiliation></author><author><name sortKey="Pedersen, Terje R" sort="Pedersen, Terje R" uniqKey="Pedersen T" first="Terje R." last="Pedersen">Terje R. Pedersen</name><affiliation><nlm:aff id="A4">Center of Preventive Medicine, Oslo University Hospital, Ulleval and University of Oslo, Norway</nlm:aff></affiliation></author><author><name sortKey="Larosa, John C" sort="Larosa, John C" uniqKey="Larosa J" first="John C." last="Larosa">John C. Larosa</name><affiliation><nlm:aff id="A5">State University of New York Health Science Center, Brooklyn, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Welch, K M A" sort="Welch, K M A" uniqKey="Welch K" first="K. M. A." last="Welch">K. M. A. Welch</name><affiliation><nlm:aff id="A6">Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA</nlm:aff></affiliation></author><author><name sortKey="Amarenco, Pierre" sort="Amarenco, Pierre" uniqKey="Amarenco P" first="Pierre" last="Amarenco">Pierre Amarenco</name><affiliation><nlm:aff id="A7">Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Demicco, David A" sort="Demicco, David A" uniqKey="Demicco D" first="David A." last="Demicco">David A. Demicco</name><affiliation><nlm:aff id="A8">Global Pharmaceuticals Pfizer, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Tonkin, Andrew M" sort="Tonkin, Andrew M" uniqKey="Tonkin A" first="Andrew M." last="Tonkin">Andrew M. Tonkin</name><affiliation><nlm:aff id="A9">Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Sullivan, David R" sort="Sullivan, David R" uniqKey="Sullivan D" first="David R." last="Sullivan">David R. Sullivan</name><affiliation><nlm:aff id="A10">Department of Biochemistry and Lipid Clinic, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia;</nlm:aff></affiliation></author><author><name sortKey="Kirby, Adrienne" sort="Kirby, Adrienne" uniqKey="Kirby A" first="Adrienne" last="Kirby">Adrienne Kirby</name><affiliation><nlm:aff id="A11">NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Colhoun, Helen M" sort="Colhoun, Helen M" uniqKey="Colhoun H" first="Helen M." last="Colhoun">Helen M. Colhoun</name><affiliation><nlm:aff id="A12">Medical Research Institute, University of Dundee, Dundee, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Hitman, Graham A" sort="Hitman, Graham A" uniqKey="Hitman G" first="Graham A." last="Hitman">Graham A. Hitman</name><affiliation><nlm:aff id="A13">Centre for Diabetes, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Betteridge, D John" sort="Betteridge, D John" uniqKey="Betteridge D" first="D. John" last="Betteridge">D. John Betteridge</name><affiliation><nlm:aff id="A14">Department of Medicine, Royal Free and University College Medical School, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Durrington, Paul N" sort="Durrington, Paul N" uniqKey="Durrington P" first="Paul N." last="Durrington">Paul N. Durrington</name><affiliation><nlm:aff id="A15">School of Biomedicine, University of Manchester, Manchester, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Clearfield, Michael B" sort="Clearfield, Michael B" uniqKey="Clearfield M" first="Michael B." last="Clearfield">Michael B. Clearfield</name><affiliation><nlm:aff id="A16">Touro University, Mare Island, California, USA</nlm:aff></affiliation></author><author><name sortKey="Downs, John R" sort="Downs, John R" uniqKey="Downs J" first="John R." last="Downs">John R. Downs</name><affiliation><nlm:aff id="A17">Department of Medicine, University of Texas Health Science Center, and VERDICT, South Texas Veterans Health Care System, San Antonio, Texas, USA</nlm:aff></affiliation></author><author><name sortKey="Gotto, Antonio M" sort="Gotto, Antonio M" uniqKey="Gotto A" first="Antonio M." last="Gotto">Antonio M. Gotto</name><affiliation><nlm:aff id="A18">Weill Cornell Medical College, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Ridker, Paul M" sort="Ridker, Paul M" uniqKey="Ridker P" first="Paul M." last="Ridker">Paul M. Ridker</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts, USA</nlm:aff></affiliation></author><author><name sortKey="Kastelein, John J P" sort="Kastelein, John J P" uniqKey="Kastelein J" first="John J. P." last="Kastelein">John J. P. Kastelein</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23965489</idno><idno type="pmc">3807966</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3807966</idno><idno type="RBID">PMC:3807966</idno><idno type="doi">10.1161/CIRCULATIONAHA.113.002670</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001C66</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001C66</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Levels and changes of HDL cholesterol and apolipoprotein A-I in relation to risk of cardiovascular events among statin-treated patients; a meta-analysis</title><author><name sortKey="Boekholdt, S Matthijs" sort="Boekholdt, S Matthijs" uniqKey="Boekholdt S" first="S. Matthijs" last="Boekholdt">S. Matthijs Boekholdt</name><affiliation><nlm:aff id="A1">Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Arsenault, Benoit J" sort="Arsenault, Benoit J" uniqKey="Arsenault B" first="Benoit J." last="Arsenault">Benoit J. Arsenault</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Hovingh, G Kees" sort="Hovingh, G Kees" uniqKey="Hovingh G" first="G. Kees" last="Hovingh">G. Kees Hovingh</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Mora, Samia" sort="Mora, Samia" uniqKey="Mora S" first="Samia" last="Mora">Samia Mora</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts, USA</nlm:aff></affiliation></author><author><name sortKey="Pedersen, Terje R" sort="Pedersen, Terje R" uniqKey="Pedersen T" first="Terje R." last="Pedersen">Terje R. Pedersen</name><affiliation><nlm:aff id="A4">Center of Preventive Medicine, Oslo University Hospital, Ulleval and University of Oslo, Norway</nlm:aff></affiliation></author><author><name sortKey="Larosa, John C" sort="Larosa, John C" uniqKey="Larosa J" first="John C." last="Larosa">John C. Larosa</name><affiliation><nlm:aff id="A5">State University of New York Health Science Center, Brooklyn, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Welch, K M A" sort="Welch, K M A" uniqKey="Welch K" first="K. M. A." last="Welch">K. M. A. Welch</name><affiliation><nlm:aff id="A6">Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA</nlm:aff></affiliation></author><author><name sortKey="Amarenco, Pierre" sort="Amarenco, Pierre" uniqKey="Amarenco P" first="Pierre" last="Amarenco">Pierre Amarenco</name><affiliation><nlm:aff id="A7">Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Demicco, David A" sort="Demicco, David A" uniqKey="Demicco D" first="David A." last="Demicco">David A. Demicco</name><affiliation><nlm:aff id="A8">Global Pharmaceuticals Pfizer, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Tonkin, Andrew M" sort="Tonkin, Andrew M" uniqKey="Tonkin A" first="Andrew M." last="Tonkin">Andrew M. Tonkin</name><affiliation><nlm:aff id="A9">Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Sullivan, David R" sort="Sullivan, David R" uniqKey="Sullivan D" first="David R." last="Sullivan">David R. Sullivan</name><affiliation><nlm:aff id="A10">Department of Biochemistry and Lipid Clinic, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia;</nlm:aff></affiliation></author><author><name sortKey="Kirby, Adrienne" sort="Kirby, Adrienne" uniqKey="Kirby A" first="Adrienne" last="Kirby">Adrienne Kirby</name><affiliation><nlm:aff id="A11">NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Colhoun, Helen M" sort="Colhoun, Helen M" uniqKey="Colhoun H" first="Helen M." last="Colhoun">Helen M. Colhoun</name><affiliation><nlm:aff id="A12">Medical Research Institute, University of Dundee, Dundee, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Hitman, Graham A" sort="Hitman, Graham A" uniqKey="Hitman G" first="Graham A." last="Hitman">Graham A. Hitman</name><affiliation><nlm:aff id="A13">Centre for Diabetes, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Betteridge, D John" sort="Betteridge, D John" uniqKey="Betteridge D" first="D. John" last="Betteridge">D. John Betteridge</name><affiliation><nlm:aff id="A14">Department of Medicine, Royal Free and University College Medical School, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Durrington, Paul N" sort="Durrington, Paul N" uniqKey="Durrington P" first="Paul N." last="Durrington">Paul N. Durrington</name><affiliation><nlm:aff id="A15">School of Biomedicine, University of Manchester, Manchester, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Clearfield, Michael B" sort="Clearfield, Michael B" uniqKey="Clearfield M" first="Michael B." last="Clearfield">Michael B. Clearfield</name><affiliation><nlm:aff id="A16">Touro University, Mare Island, California, USA</nlm:aff></affiliation></author><author><name sortKey="Downs, John R" sort="Downs, John R" uniqKey="Downs J" first="John R." last="Downs">John R. Downs</name><affiliation><nlm:aff id="A17">Department of Medicine, University of Texas Health Science Center, and VERDICT, South Texas Veterans Health Care System, San Antonio, Texas, USA</nlm:aff></affiliation></author><author><name sortKey="Gotto, Antonio M" sort="Gotto, Antonio M" uniqKey="Gotto A" first="Antonio M." last="Gotto">Antonio M. Gotto</name><affiliation><nlm:aff id="A18">Weill Cornell Medical College, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Ridker, Paul M" sort="Ridker, Paul M" uniqKey="Ridker P" first="Paul M." last="Ridker">Paul M. Ridker</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts, USA</nlm:aff></affiliation></author><author><name sortKey="Kastelein, John J P" sort="Kastelein, John J P" uniqKey="Kastelein J" first="John J. P." last="Kastelein">John J. P. Kastelein</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author></analytic><series><title level="j">Circulation</title><idno type="ISSN">0009-7322</idno><idno type="eISSN">1524-4539</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">It is unclear whether levels of high-density lipoprotein cholesterol (HDL-C) or apolipoprotein A-I (apoA-I) remain inversely associated with cardiovascular risk among patients who achieve very low levels of low-density lipoprotein cholesterol (LDL-C) on statin therapy. It is also unknown whether a rise in HDL-C or apoA-I after initiation of statin therapy is associated with a reduced cardiovascular risk.</p></sec><sec id="S2"><title>Methods and results</title><p id="P2">We performed a meta-analysis of 8 statin trials in which lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up. Individual patient data were obtained for 38,153 trial participants allocated to statin therapy, of whom 5387 suffered a major cardiovascular event. HDL-C levels were associated with a reduced risk of major cardiovascular events (adjusted hazard ratio 0.83, 95%CI 0.81–0.86 per 1 standard deviation increment), as were apoA-I levels (HR 0.79, 95%CI 0.72–0.82). This association was also observed among patients achieving on-statin LDL-C levels < 50 mg/dL. An increase of HDL-C was not associated with reduced cardiovascular risk (HR 0.98, 95%CI 0.94–1.01 per 1 standard deviation increment), whereas a rise in apoA-I was (HR 0.93, 95%CI 0.90–0.97).</p></sec><sec id="S3"><title>Conclusions</title><p id="P3">Among patients treated with statin therapy, HDL-C and apoA-I levels were strongly associated with a reduced cardiovascular risk, even among those achieving very low LDL-C. An apoA-I increase was associated with a reduced risk of major cardiovascular events, whereas for HDL-C this was not the case. These findings suggest that therapies that increase apoA-I concentration require further exploration with regard to cardiovascular risk reduction.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0147763</journal-id><journal-id journal-id-type="pubmed-jr-id">2979</journal-id><journal-id journal-id-type="nlm-ta">Circulation</journal-id><journal-id journal-id-type="iso-abbrev">Circulation</journal-id><journal-title-group><journal-title>Circulation</journal-title></journal-title-group><issn pub-type="ppub">0009-7322</issn><issn pub-type="epub">1524-4539</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23965489</article-id><article-id pub-id-type="pmc">3807966</article-id><article-id pub-id-type="doi">10.1161/CIRCULATIONAHA.113.002670</article-id><article-id pub-id-type="manuscript">NIHMS517681</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Levels and changes of HDL cholesterol and apolipoprotein A-I in relation to risk of cardiovascular events among statin-treated patients; a meta-analysis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Boekholdt</surname><given-names>S. Matthijs</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Arsenault</surname><given-names>Benoit J.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Hovingh</surname><given-names>G. Kees</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Mora</surname><given-names>Samia</given-names></name><degrees>MD, MHS</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Pedersen</surname><given-names>Terje R.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>LaRosa</surname><given-names>John C.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Welch</surname><given-names>K.M.A.</given-names></name><degrees>MB, ChB</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Amarenco</surname><given-names>Pierre</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>DeMicco</surname><given-names>David A.</given-names></name><degrees>DPharm</degrees><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Tonkin</surname><given-names>Andrew M.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><name><surname>Sullivan</surname><given-names>David R.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A10">10</xref></contrib><contrib contrib-type="author"><name><surname>Kirby</surname><given-names>Adrienne</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A11">11</xref></contrib><contrib contrib-type="author"><name><surname>Colhoun</surname><given-names>Helen M.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A12">12</xref></contrib><contrib contrib-type="author"><name><surname>Hitman</surname><given-names>Graham A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A13">13</xref></contrib><contrib contrib-type="author"><name><surname>Betteridge</surname><given-names>D. John</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A14">14</xref></contrib><contrib contrib-type="author"><name><surname>Durrington</surname><given-names>Paul N.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A15">15</xref></contrib><contrib contrib-type="author"><name><surname>Clearfield</surname><given-names>Michael B.</given-names></name><degrees>DO</degrees><xref ref-type="aff" rid="A16">16</xref></contrib><contrib contrib-type="author"><name><surname>Downs</surname><given-names>John R.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A17">17</xref></contrib><contrib contrib-type="author"><name><surname>Gotto</surname><given-names>Antonio M.</given-names><suffix>Jr</suffix></name><degrees>MD, DPhil</degrees><xref ref-type="aff" rid="A18">18</xref></contrib><contrib contrib-type="author"><name><surname>Ridker</surname><given-names>Paul M.</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Kastelein</surname><given-names>John J.P.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands</aff><aff id="A2"><label>2</label>Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</aff><aff id="A3"><label>3</label>Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts, USA</aff><aff id="A4"><label>4</label>Center of Preventive Medicine, Oslo University Hospital, Ulleval and University of Oslo, Norway</aff><aff id="A5"><label>5</label>State University of New York Health Science Center, Brooklyn, New York, USA</aff><aff id="A6"><label>6</label>Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA</aff><aff id="A7"><label>7</label>Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France</aff><aff id="A8"><label>8</label>Global Pharmaceuticals Pfizer, New York, New York, USA</aff><aff id="A9"><label>9</label>Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia</aff><aff id="A10"><label>10</label>Department of Biochemistry and Lipid Clinic, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia;</aff><aff id="A11"><label>11</label>NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</aff><aff id="A12"><label>12</label>Medical Research Institute, University of Dundee, Dundee, United Kingdom</aff><aff id="A13"><label>13</label>Centre for Diabetes, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom</aff><aff id="A14"><label>14</label>Department of Medicine, Royal Free and University College Medical School, London, United Kingdom</aff><aff id="A15"><label>15</label>School of Biomedicine, University of Manchester, Manchester, United Kingdom</aff><aff id="A16"><label>16</label>Touro University, Mare Island, California, USA</aff><aff id="A17"><label>17</label>Department of Medicine, University of Texas Health Science Center, and VERDICT, South Texas Veterans Health Care System, San Antonio, Texas, USA</aff><aff id="A18"><label>18</label>Weill Cornell Medical College, New York, New York, USA</aff><author-notes><corresp id="FN1">Corresponding author: J.J.P. Kastelein, MD, PhD, Department of Vascular Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, <email>j.j.kastelein@amc.uva.nl</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>23</day><month>9</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>21</day><month>8</month><year>2013</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>10</month><year>2013</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>10</month><year>2014</year></pub-date><volume>128</volume><issue>14</issue><elocation-id>10.1161/CIRCULATIONAHA.113.002670</elocation-id><abstract><sec id="S1"><title>Background</title><p id="P1">It is unclear whether levels of high-density lipoprotein cholesterol (HDL-C) or apolipoprotein A-I (apoA-I) remain inversely associated with cardiovascular risk among patients who achieve very low levels of low-density lipoprotein cholesterol (LDL-C) on statin therapy. It is also unknown whether a rise in HDL-C or apoA-I after initiation of statin therapy is associated with a reduced cardiovascular risk.</p></sec><sec id="S2"><title>Methods and results</title><p id="P2">We performed a meta-analysis of 8 statin trials in which lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up. Individual patient data were obtained for 38,153 trial participants allocated to statin therapy, of whom 5387 suffered a major cardiovascular event. HDL-C levels were associated with a reduced risk of major cardiovascular events (adjusted hazard ratio 0.83, 95%CI 0.81–0.86 per 1 standard deviation increment), as were apoA-I levels (HR 0.79, 95%CI 0.72–0.82). This association was also observed among patients achieving on-statin LDL-C levels < 50 mg/dL. An increase of HDL-C was not associated with reduced cardiovascular risk (HR 0.98, 95%CI 0.94–1.01 per 1 standard deviation increment), whereas a rise in apoA-I was (HR 0.93, 95%CI 0.90–0.97).</p></sec><sec id="S3"><title>Conclusions</title><p id="P3">Among patients treated with statin therapy, HDL-C and apoA-I levels were strongly associated with a reduced cardiovascular risk, even among those achieving very low LDL-C. An apoA-I increase was associated with a reduced risk of major cardiovascular events, whereas for HDL-C this was not the case. These findings suggest that therapies that increase apoA-I concentration require further exploration with regard to cardiovascular risk reduction.</p></sec></abstract><kwd-group><kwd>high-density lipoprotein cholesterol</kwd><kwd>apolipoprotein</kwd><kwd>meta-analysis</kwd><kwd>cardiovascular outcomes</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Heart, Lung, and Blood Institute : NHLBI</funding-source><award-id>R01 HL117861 || HL</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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