Relationship of Oxidized Phospholipids on Apolipoprotein B-100 to Cardiovascular Outcomes in Patients Treated With Intensive Versus Moderate Atorvastatin Therapy The TNT Trial

被引：61

作者：

Byun, Young Sup ^{[1
,2
]}

Lee, Jun-Hee ^{[1
,3
]}

Arsenault, Benoit J. ^{[4
]}

Yang, Xiaohong ^{[1
]}

Bao, Weihang ^{[5
]}

DeMicco, David ^{[5
]}

Laskey, Rachel ^{[5
]}

Witztum, Joseph L. ^{[6
]}

Tsimikas, Sotirios ^{[1
]}

机构：

[1] Univ Calif San Diego, Div Cardiovasc Dis, La Jolla, CA 92093 USA

[2] Inje Univ, Coll Med, Sanggye Paik Hosp, Div Cardiol,Dept Internal Med, Seoul, South Korea

[3] Hallym Univ, Med Ctr, Div Cardiol, Kang Dong Sacred Heart Hosp, Seoul, South Korea

[4] Inst Univ Cardiol & Pneumol Quebec, Ctr Rech, Quebec City, PQ, Canada

[5] Pfizer Inc, New York, NY USA

[6] Univ Calif San Diego, Div Endocrinol Metab, La Jolla, CA 92093 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2015年 / 65卷 / 13期

基金：

美国国家卫生研究院;

关键词：

atherosclerosis; biomarker; coronary heart disease; inflammatory; oxidation-specific epitope; LOW-DENSITY-LIPOPROTEIN; OXIDATION-SPECIFIC EPITOPES; ACUTE CORONARY SYNDROMES; PLASMA-LEVELS; ATHEROSCLEROTIC LESIONS; IMMUNOLOGICAL RESPONSES; PERCUTANEOUS CORONARY; ARTERY-DISEASE; RISK-FACTORS; BIOMARKERS;

D O I：

10.1016/j.jacc.2015.01.050

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) is a biomarker of increased risk for major adverse cardiovascular events (MACE) in community cohorts, but its role in patients with stable coronary heart disease (CHD) is unknown. OBJECTIVES This study sought to examine the relationship between these oxidative biomarkers and cardiovascular outcomes in patients with established CHD. METHODS In a random sample from the TNT (Treating to New Targets) trial, OxPL-apoB levels were measured in 1,503 patients at randomization (after an 8-week run-in period taking atorvastatin 10 mg) and 1 year after being randomized to atorvastatin 10 or 80 mg. We examined the association between baseline levels of OxPL-apoB and MACE, defined as death from CHD, nonfatal myocardial infarction, resuscitation after cardiac arrest, and fatal/nonfatal stroke, as well as the effect of statin therapy on OxPL-apoB levels and MACE. RESULTS Patients with events (n = 156) had higher randomization levels of OxPL-apoB than those without events (p = 0.025). For the overall cohort, randomization levels of OxPL-apoB predicted subsequent MACE (hazard ratio [HR]: 1.21; 95% confidence interval: 1.04 to 1.41; p = 0.018) per doubling and tertile 3 versus tertile 1 (hazard ratio: 1.69; 95% confidence interval [CI]: 1.14 to 2.49; p = 0.01) after multivariate adjustment for age, sex, body mass index, among others, and treatment assignment. In the atorvastatin 10-mg group, tertile 3 was associated with a higher risk of MACE compared to the first tertile (HR: 2.08; 95% CI: 1.20 to 3.61; p = 0.01) but this was not significant in the atorvastatin 80-mg group (HR: 1.40; 95% CI: 0.80 to 2.46; p = 0.24). CONCLUSIONS Elevated OxPL-apoB levels predict secondary MACE in patients with stable CHD, a risk that is mitigated by atorvastatin 80 mg. (C) 2015 by the American College of Cardiology Foundation.

引用

页码：1286 / 1295

页数：10

共 37 条

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