Abstract | BACKGROUND: OBJECTIVES: To examine the effects of ERN treatment on lipoprotein particles and GlycA, a new marker of systemic inflammation, and their relations with incident CVD events including mortality. METHODS: GlycA and very low-density lipoprotein, low-density lipoprotein ( LDL), and high-density lipoprotein (HDL) particle subclasses were quantified by nuclear magnetic resonance spectroscopy using available stored baseline (n = 2754) and 1-year in-trial (n = 2581) samples. Associations with CVD events and all-cause mortality were assessed using multivariable Cox proportional hazards regression adjusted for age, sex, diabetes, treatment assignment, and lipoproteins. RESULTS: Compared to placebo, ERN treatment lowered very low-density lipoprotein and LDL and increased HDL particle concentrations, increased LDL and HDL particle sizes (all P < .0001), but did not affect GlycA. Baseline and in-trial GlycA levels were associated with increased risk of CVD events: hazard ratio (HR) per SD increment, 1.17 (95% confidence interval [CI], 1.06-1.28) and 1.13 (1.02-1.26), respectively. However, none of the lipoprotein particle classes or subclasses was associated with incident CVD. By contrast, all-cause mortality was significantly associated with both GlycA (baseline HR: 1.46 [1.22-1.75]; in-trial HR: 1.41 [1.24-1.60]) and low levels of small HDL particles (baseline HR: 0.69 [0.56-0.86]; in-trial HR: 0.69 [0.56-0.86]). CONCLUSIONS:
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Authors | James D Otvos, John R Guyton, Margery A Connelly, Sydney Akapame, Vera Bittner, Steven L Kopecky, Megan Lacy, Santica M Marcovina, Joseph B Muhlestein, William E Boden |
Journal | Journal of clinical lipidology
(J Clin Lipidol)
2018 Mar - Apr
Vol. 12
Issue 2
Pg. 348-355.e2
ISSN: 1933-2874 [Print] United States |
PMID | 29409728
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2018 National Lipid Association. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Anticholesteremic Agents
- Biomarkers
- Cholesterol, HDL
- Delayed-Action Preparations
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Hypolipidemic Agents
- Lipoproteins
- Lipoproteins, HDL
- Triglycerides
- Niacin
- Ezetimibe
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Topics |
- Aged
- Anticholesteremic Agents
(therapeutic use)
- Biomarkers
(blood)
- Cardiovascular Diseases
(blood, drug therapy, mortality)
- Cholesterol, HDL
(blood)
- Delayed-Action Preparations
(therapeutic use)
- Double-Blind Method
- Ezetimibe
(therapeutic use)
- Female
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
(therapeutic use)
- Hypolipidemic Agents
(therapeutic use)
- Kaplan-Meier Estimate
- Lipoproteins
(blood)
- Lipoproteins, HDL
(blood)
- Male
- Middle Aged
- Niacin
(therapeutic use)
- Survival Rate
- Triglycerides
(blood)
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