Abstract 1091: Which Lipid Risk Factors Predict Future Vascular Events in Coronary Patients Receiving Statins?
Background and Objective: Statins are a cornerstone in the treatment of patients with established coronary artery disease (CAD), but vascular risk in these patients remains high. Because it is not known which lipid parameters or other risk factors predict CAD progression despite statin treatment, we performed a prospective study on statin-treated angiographied coronary patients.
Methods: We prospectively recorded vascular events over 6 years in 476 consecutive patients. At the baseline coronary angiography, lipids and lipoproteins were measured from fasting serum samples.
Results: We recorded 146 vascular events (107 coronary and 39 non-coronary events). Among lipid parameters, in Cox regression analyses, low HDL cholesterol (standardized adjusted hazard ratio (HR) = 0.747 [0.618 – 0.904]; p = 0.003), low apolipoprotein A (HR = 0.743 [0.625– 0.883]; p = 0.001) and a small LDL peak particle diameter (HR = 0.814 [0.693– 0.956]; p = 0.012) significantly predicted vascular events, but not total cholesterol (0.911 [0.774 –1.073]; p = 0.265), LDL cholesterol (HR = 0.924 [0.785–1.088]; p = 0.346), or apolipoprotein B (1.052 [0.896 –1.236]; p = 0.533). After multivariate adjustment for non-lipid risk factors HDL cholesterol (HR = 0.766 [0.618 – 0.950]; p = 0.015), apolipoprotein A (HR = 0.771 [0.639 – 0.931]; p = 0.007), and the LDL peak particle diameter (HR = 0.801 [0.674 – 0.953]; p = 0.012) remained significantly predictive for the incidence of vascular events.
Conclusions: We conclude that low HDL cholesterol, low apolipoprotein A, and small LDL particles are the main lipid risk factors for the incidence of vascular events in coronary patients on statin treatment.