Abstract 15386: Factors Predicting Cardiovascular Events in Statin-Treated Diabetic and Non-Diabetic Coronary Patients: A Prospective Cohort Study
Objectives: We aimed at identifying which lipid factors drive vascular risk in statin treated patients with coronary artery disease (CAD).
Methods: We recorded vascular events over a mean period of 7.2 years in 491 consecutive statin-treated patients with angiographically proven stable CAD, covering 3518 patient-years.
Results: In the total population, low HDL cholesterol (standardized adjusted HR 0.80 [0.67–0.94]; p=0.009), low apolipoprotein A1 (0.84 [0.72–0.98]; p=0.022), a small LDL particle diameter (0.84 [0.72–0.98]; p=0.023), and high triglycerides (1.18 [1.04–1.35]; p=0.013) predicted vascular events, but not total cholesterol, LDL cholesterol, or apolipoprotein B. Factor analysis in the lipid profiles of our patients revealed an HDL-related factor and an LDL-related factor. Concordant with the results for individual lipid parameters, the HDL-related factor (0.76 [0.65–0.90]; p = 0.001) but not the LDL-related factor (p=0.644) predicted vascular events. Patients with type 2 diabetes (T2DM; n=116) were at a higher vascular risk than non-diabetic subjects (52.6% vs. 36.8%; p = 0.002), and like in the total population the HDL-related factor (0.63 [0.49–0.81]; p<0.001) but not the LDL-related factor (p=0.976) predicted vascular risk in diabetic patients.
Conclusions: The pattern of low HDL cholesterol, low apolipoprotein A1, small LDL particles, and high triglycerides drives vascular risk in statin-treated coronary patients, particularly in those with T2DM.
- © 2010 by American Heart Association, Inc.