Lp(a) (Lipoprotein(a)) Levels Predict Progression of Carotid Atherosclerosis in Subjects With Atherosclerotic Cardiovascular Disease on Intensive Lipid Therapy: An Analysis of the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes) Carotid Magnetic Resonance Imaging SubstudyBrief Report

被引:36
作者
Hippe, Daniel S. [1 ]
Phan, Binh An P. [4 ]
Sun, Jie [1 ]
Isquith, Daniel A. [2 ]
O'Brien, Kevin D. [2 ]
Crouse, John R. [5 ]
Anderson, Todd [6 ]
Huston, John [7 ]
Marcovina, Santica M. [8 ]
Hatsukami, Thomas S. [3 ]
Yuan, Chun [1 ]
Zhao, Xue-Qiao [2 ]
机构
[1] Univ Washington, Sch Med, Dept Radiol, Seattle, WA 98195 USA
[2] Univ Washington, Sch Med, Div Cardiol, Seattle, WA USA
[3] Univ Washington, Sch Med, Dept Surg, Div Vasc Surg, Seattle, WA 98195 USA
[4] Univ Calif San Francisco, San Francisco Gen Hosp, Div Cardiol, San Francisco, CA USA
[5] Wake Forest Sch Med, Dept Med, Winston Salem, NC USA
[6] Univ Calgary, Libin Cardiovasc Inst Alberta, Calgary, AB, Canada
[7] Mayo Clin, Dept Radiol, Rochester, MN USA
[8] Univ Washington, Northwest Lipid Metab & Diabet Res Labs, Seattle, WA 98195 USA
关键词
atherosclerosis; lipids; lipoprotein; lipoprotein(a); lp(a); risk factors; triglycerides; CORONARY-HEART-DISEASE; STATIN THERAPY; MYOCARDIAL-INFARCTION; CHOLESTEROL LEVELS; ARTERIAL BIOLOGY; REDUCING LIPIDS; EVENTS; RISK; NIACIN; TRIAL;
D O I
10.1161/ATVBAHA.117.310368
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To assess whether Lp(a) (lipoprotein(a)) levels and other lipid levels were predictive of progression of atherosclerosis burden as assessed by carotid magnetic resonance imaging in subjects who have been treated with LDL-C (low-density lipoprotein cholesterol)-lowering therapy and participated in the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes). Approach and Results AIM-HIGH was a randomized, double-blind study of subjects with established vascular disease, elevated triglycerides, and low HDL-C (high-density lipoprotein cholesterol). One hundred fifty-two AIM-HIGH subjects underwent both baseline and 2-year follow-up carotid artery magnetic resonance imaging. Plaque burden was measured by the percent wall volume (%WV) of the carotid artery. Associations between annualized change in %WV with baseline and on-study (1 year) lipid variables were evaluated using multivariate linear regression and the Bonferroni correction to account for multiple comparisons. Average %WV at baseline was 41.66.8% and annualized change in %WV over 2 years ranged from -3.2% to 3.7% per year (mean: 0.2 +/- 1.1% per year; P=0.032). Increases in %WV were significantly associated with higher baseline Lp(a) (=0.34 per 1-SD increase of Lp(a); 95% confidence interval, 0.15-0.52; P<0.001) after adjusting for clinical risk factors and other lipid levels. On-study Lp(a) had a similar positive association with %WV progression (=0.33; 95% confidence interval, 0.15-0.52; P<0.001). Conclusions Despite intensive lipid therapy, aimed at aggressively lowering LDL-C to <70 mg/dL, carotid atherosclerosis continued to progress as assessed by carotid magnetic resonance imaging and that elevated Lp(a) levels were independent predictors of increases in atherosclerosis burden.
引用
收藏
页码:673 / 678
页数:6
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