Abstract 14026: Remnant Lipoprotein Cholesterol Fractions and Risk for Cardiovascular Events in the Jackson Heart and Framingham Offspring Studies: A Meta-Analysis
Introduction: Remnant lipoproteins include small very low-density lipoproteins (VLDL3) and intermediate-density lipoproteins (IDL). The relationships between remnant lipoproteins (RLP) and risk for coronary heart disease (CHD) related events are incompletely characterized.
Hypothesis: We quantified the relationship between remnant lipoprotein cholesterol with risk for CHD events by performing a meta-analysis of persons enrolled in the Jackson Heart (JHS) and Framingham Offspring (FOS) Studies. We hypothesized that RLP cholesterol is associated with increased CV risk.
Methods: This analysis incorporated the results for 818 (exam 6) and 4114 (from start of study) men and women without prevalent CHD from the FOS and JHS, respectively, followed up over 8 yrs. Serum lipoproteins were subfractionated by vertical auto profile (VAP) testing. The relationships between VLDL-C3, IDL-C, and total remnant lipoprotein cholesterol (RLP-C) to incident CHD events (myocardial infarction, coronary mortality, and coronary revascularizations) was assessed using multivariate Cox Proportional hazards regression, adjusting for age, sex, BMI, smoking status, SBP, DBP, lipid treatment, and diabetes mellitus. Hazard ratios per a 1 standard deviation increase of each VAP lipid, and their 95% confidence intervals were calculated and the hazard ratios were then combined across FHS and JHS using a fixed-effects meta-analysis.
Results: For the combined group, VLDL-C3 shows a trend for increased risk (HR 1.15; 95% CI 1.00-1.32; p=0.052), while IDL-C (HR 1.26; 95% CI 1.08-1.47, p=0.003) and total RLP-C (HR 1.23; 95% CI 1.06-1.42, p=0.006) correlate significantly with increased risk for CHD events. These results were consistent with results for each cohort (FOS vs. JHS) considered individually for VLDL-C3 (HR 1.36; p=0.068 vs. HR 1.11; p=0.20), IDL-C (HR 1.47; 95% CI 1.04-2.06, p=0.027 vs. HR 1.21; 95% CI 1.02-1.44, p=0.025), and total RLP-C (HR 1.46; 95% CI 1.05-2.04, p=0.026 vs. HR 1.18; 95% CI 1.00-1.39, P=0.049).
Conclusions: In the FHS and JHS, the cholesterol associated with IDL and total RLP correlates with increased risk for CV events, while VLDL3 shows a positive trend but did not attain significance. These results reinforce the need to treat non-HDL-C.
- © 2013 by American Heart Association, Inc.