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(Circulation. 2008;117:e175.)
© 2008 American Heart Association, Inc.

Correspondence

Response to Letter Regarding Article, "Statin Use in Patients With Extremely Low Low-Density Lipoprotein Levels Is Associated With Improved Survival"

Nicholas J. Leeper, MD; Reza Ardehali, MD, PhD; Emil M. deGoma, MD; Paul A. Heidenreich, MD, MS

Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif

Anderson and Salgado offer the hypothesis that increases in high-density lipoprotein (HDL) cholesterol may explain in part the benefit of statins that we observed in patients with extremely low low-density lipoprotein (LDL) values. Although we cannot answer the question directly, we have examined the association of HDL cholesterol levels and outcome in this cohort.¹ We found that low HDL cholesterol remains a risk factor for death and ischemic heart disease events in this group with an LDL cholesterol <60 mg/dL. This association between HDL and outcome in patients with low LDL cholesterol was recently confirmed in a separate population.² Thus, we agree that the likely benefit of statins in patients with low LDL cholesterol may be due in part to an increase in HDL cholesterol.

	Acknowledgments

 
Disclosures

None.

	References

Top References

 
1. deGoma EM, Leeper NJ, Heidenreich PA. Clinical significance of high-density lipoprotein cholesterol in patients with low low-density lipoprotein cholesterol. J Am Coll Cardiol. 2008; 51: 49–55.[Abstract/Free Full Text]

2. Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, Kastelein JJ, Bittner V, Fruchart JC; Treating to New Targets Investigators. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007; 357: 1301–1310.[Abstract/Free Full Text]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Leeper, N. J. Articles by Heidenreich, P. A. Search for Related Content PubMed Articles by Leeper, N. J. Articles by Heidenreich, P. A. Related Collections Lipid and lipoprotein metabolism