High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome.
OBJECTIVE:The current guideline recommends lowering low-density lipoprotein cholesterol (LDL-C) for the primary management of dyslipidemia in patients at high-risk of cardiovascular events. Patients who have achieved LDL-C levels below the recommended targets may still experience cardiovascular even...
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doaj-205e4d76f6714c58b47066115e15a2db2020-11-24T21:40:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01137e020038310.1371/journal.pone.0200383High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome.Yuichi OzakiAtsushi TanakaTsuyoshi NishiguchiKenichi KomukaiAkira TaruyaKeisuke SatogamiManabu KashiwagiAkio KuroiYoshiki MatsuoYasushi InoHironori KitabataTakashi KuboTakeshi HozumiTakashi AkasakaOBJECTIVE:The current guideline recommends lowering low-density lipoprotein cholesterol (LDL-C) for the primary management of dyslipidemia in patients at high-risk of cardiovascular events. Patients who have achieved LDL-C levels below the recommended targets may still experience cardiovascular events, suggesting additional therapeutic targets beyond LDL-C. The aim of this study was to investigate whether high-density lipoprotein cholesterol (HDL-C) levels had an impact on plaque stabilization in patients with acute coronary syndrome (ACS). METHODS:This study consisted of 90 ACS patients with untreated dyslipidemia. In optical coherence tomography (OCT) analysis, a plaque with fibrous cap thickness ≦160 μm was defined as a high-risk plaque. We registered one high-risk plaque per one patient by baseline OCT imaging, and then administrated high-intensity statin. Based on the follow-up OCT results, patients whose registered plaque was no longer high-risk plaque were classified into a responder group and the remains into a non-responder group. RESULTS:No differences were observed in the baseline LDL-C and HDL-C levels between the two groups. Reduction of LDL-C levels (δ LDL-C: -53 ± 21 mg/dL vs. -42 ± 29 mg/dL, p = 0.036) and increase of HDL-C levels (δ HDL-C: 2.5 ± 5.9 mg/dL vs. -0.3 ± 6.7 mg/dL, p = 0.039) were greater in the responder group. On multivariate logistic regression analysis, δ LDL-C levels (OR: 0.956, 95% CI: 0.921-0.993; p = 0.020) and δ HDL-C levels (OR: 1.143; 95% CI: 1.005-1.300, p = 0.041) were independent contributors for plaque stabilization. CONCLUSIONS:Increase of HDL-C levels is associated with plaque stabilization in patients with ACS. HDL-C could be a therapeutic target for residual risk management.http://europepmc.org/articles/PMC6040709?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuichi Ozaki Atsushi Tanaka Tsuyoshi Nishiguchi Kenichi Komukai Akira Taruya Keisuke Satogami Manabu Kashiwagi Akio Kuroi Yoshiki Matsuo Yasushi Ino Hironori Kitabata Takashi Kubo Takeshi Hozumi Takashi Akasaka |
spellingShingle |
Yuichi Ozaki Atsushi Tanaka Tsuyoshi Nishiguchi Kenichi Komukai Akira Taruya Keisuke Satogami Manabu Kashiwagi Akio Kuroi Yoshiki Matsuo Yasushi Ino Hironori Kitabata Takashi Kubo Takeshi Hozumi Takashi Akasaka High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome. PLoS ONE |
author_facet |
Yuichi Ozaki Atsushi Tanaka Tsuyoshi Nishiguchi Kenichi Komukai Akira Taruya Keisuke Satogami Manabu Kashiwagi Akio Kuroi Yoshiki Matsuo Yasushi Ino Hironori Kitabata Takashi Kubo Takeshi Hozumi Takashi Akasaka |
author_sort |
Yuichi Ozaki |
title |
High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome. |
title_short |
High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome. |
title_full |
High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome. |
title_fullStr |
High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome. |
title_full_unstemmed |
High-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome. |
title_sort |
high-density lipoprotein cholesterol as a therapeutic target for residual risk in patients with acute coronary syndrome. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2018-01-01 |
description |
OBJECTIVE:The current guideline recommends lowering low-density lipoprotein cholesterol (LDL-C) for the primary management of dyslipidemia in patients at high-risk of cardiovascular events. Patients who have achieved LDL-C levels below the recommended targets may still experience cardiovascular events, suggesting additional therapeutic targets beyond LDL-C. The aim of this study was to investigate whether high-density lipoprotein cholesterol (HDL-C) levels had an impact on plaque stabilization in patients with acute coronary syndrome (ACS). METHODS:This study consisted of 90 ACS patients with untreated dyslipidemia. In optical coherence tomography (OCT) analysis, a plaque with fibrous cap thickness ≦160 μm was defined as a high-risk plaque. We registered one high-risk plaque per one patient by baseline OCT imaging, and then administrated high-intensity statin. Based on the follow-up OCT results, patients whose registered plaque was no longer high-risk plaque were classified into a responder group and the remains into a non-responder group. RESULTS:No differences were observed in the baseline LDL-C and HDL-C levels between the two groups. Reduction of LDL-C levels (δ LDL-C: -53 ± 21 mg/dL vs. -42 ± 29 mg/dL, p = 0.036) and increase of HDL-C levels (δ HDL-C: 2.5 ± 5.9 mg/dL vs. -0.3 ± 6.7 mg/dL, p = 0.039) were greater in the responder group. On multivariate logistic regression analysis, δ LDL-C levels (OR: 0.956, 95% CI: 0.921-0.993; p = 0.020) and δ HDL-C levels (OR: 1.143; 95% CI: 1.005-1.300, p = 0.041) were independent contributors for plaque stabilization. CONCLUSIONS:Increase of HDL-C levels is associated with plaque stabilization in patients with ACS. HDL-C could be a therapeutic target for residual risk management. |
url |
http://europepmc.org/articles/PMC6040709?pdf=render |
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