Atherosclerosis:HDL3-C对心血管疾病存在保护作用

2016-06-28 phylis 译 MedSci原创

背景:AIM-HIGH先前的试验结果表明,常规血脂基线水平并不能预测未来的心血管(CV)的预后。本次分析的目的是研究基线高密度脂蛋白胆固醇水平(HDL)亚类(HDL2-C、HDL3-C)、小密集的低密度脂蛋白(sdLDL-C)和甘油三酯(LDL-TG),及这些脂蛋白水平与心血管事件的相关性。方法:CV疾病和低基线HDL-C水平的患者随机分为常规治疗加安慰剂或辛伐他汀联合缓释烟酸(ERN)治疗,剂量

背景:AIM-HIGH先前的试验结果表明,常规血脂基线水平并不能预测未来的心血管(CV)的预后。本次分析的目的是研究基线高密度脂蛋白胆固醇水平(HDL)亚类(HDL2-C、HDL3-C)、低密度脂蛋白(sdLDL-C)和甘油三酯(LDL-TG),及这些脂蛋白水平与心血管事件的相关性。

方法:心血管疾病和低基线HDL-C水平的患者随机分为常规治疗加安慰剂或辛伐他汀联合缓释烟酸(ERN)治疗,剂量为1500-2000mg/d,两组按照需要增加依折麦布,维持LDL-C范围在40-80mg/dL。主要复合终点是冠心病死亡、非致死性心肌梗死、缺血性卒中、急性冠脉综合征住院治疗,或症状驱动的冠状动脉或脑血管血运重建。基于洗涤均匀试验法检测基线HDL-C, HDL3-C, sdLDL-C 和 LDL-TG的水平。HDL2-C为HDL-C和HDL3-C的差值。分析3094例受试者,这些受试者在试验招募前已经接受他汀类药物治疗。应用Cox比例风险模型确定对心血管事件有影响的脂蛋白。

结果:基线HDL3-C对心血管事件(HR 0.84)的发生存在保护作用,HDL-C、HDL2-C,sdLDL-C 和 LDL-TG与心血管事件不相关(HR 0.9;HR:1.07;HR:1.05;HR:1.03)。

结论:AIM-HIGH试验中本研究结果表明HDL3-C水平,而不是其他脂蛋白组分,可预测心血管事件。这表明HDL3亚型可能与HDL和心血管疾病负相关。

原始出处:

Albers JJ, Slee A, et al. Relationship of baseline HDL subclasses, small dense LDL and LDL triglyceride to cardiovascular events in the AIM-HIGH clinical trial. Atherosclerosis. 2016 Jun 11.


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    2016-06-30 ZGMFX24A
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    2016-06-30 lsndxfj
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