Value of LDL Particle Number and Size as
Value of LDL Particle Number and Size as Predictors of CAD in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study Value of Lipoprotein Particle Number and Size as Predictors of Coronary Artery Disease in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study Karim El Harchaoui, MD; Wim A. van der Steeg, MD; Erik S. G. Stroes, MD, Ph. D; Jan Albert Kuivenhoven, Ph. D; James D. Otvos, Ph. D; Nicholas J. Wareham, MBBS, Ph. D; Barbara A. Hutten, Ph. D; John J. P. Kastelein, MD, Ph. D; Kay-Tee Khaw, MBBChir; S. Matthijs Boekholdt, MD, Ph. D Published in JACC Clinical Trial Results. org February 6, 2007
Value of LDL Particle Number and Size as Predictors of CAD in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study: Background • The causal role of low-density lipoprotein (LDL) particles in the pathogenesis of coronary artery disease (CAD) is well established. • Low-density lipoprotein cholesterol (LDL-C) content is used as a parameter to estimate LDL-associated CAD risk. • The number of LDL particles (LDL-P) and the size has been proposed as a more reliable method reflecting atherogenicity of the LDL fraction. Clinical Trial Results. org El Harchaoui et al. JACC. 2007 Feb 6; 49 (5): 547 – 553.
Value of LDL Particle Number and Size as Predictors of CAD in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study: Background (cont. ) • This study used nuclear magnetic resonance (NMR) spectroscopy to measure both LDL-P and LDL particle size. • Associations were evaluated between LDL-P and LDL size, in comparison with LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C) as traditional markers, as was risk of future CAD in apparently healthy men and women enrolled in a large prospective cohort with moderately elevated LDL-C. Clinical Trial Results. org El Harchaoui et al. JACC. 2007 Feb 6; 49 (5): 547 – 553.
Value of LDL Particle Number and Size as Predictors of CAD in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study: Study Design 25, 663 patients aged 45 -79 years who were participants of the EPIC-Norfolk Study. 1, 003 individuals were chosen who developed CAD during 6 -year follow -up, matched for age, gender, and enrollment time with 1, 885 controls. Nest Case-Control Study. Mean follow-up 6 years Exclusion Criteria: History of heart attack or stroke. No subjects were on statin treatment. Patients who developed a fatal or non-fatal CAD during follow-up n=1, 003 g Matching Controls patients were those who remained free of CAD during follow-up n=1, 885 Calculation of odds ratios for future CAD. Evaluation of LDL-P to improve upon prediction of CAD by Framingham risk score (FRS). Clinical Trial Results. org El Harchaoui et al. JACC. 2007 Feb 6; 49 (5): 547 – 553.
Value of LDL Particle Number and Size as Predictors of CAD in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study: Odds Ratios for Future CAD • For the univariate analysis, the magnitude of the predictive value of LDL-P (OR 2. 0, 95% CI 1. 58 -2. 59) and non-HDL-C (OR 2. 14, 95% CI 1. 69 -2. 69) were greater than that of LDL-C (OR 1. 73, 95% CI 1. 37 -2. 18). • However, the additional value of LDL-P was lost after adjustment for HDL-C and triglyceride levels. Clinical Trial Results. org El Harchaoui et al. JACC. 2007 Feb 6; 49 (5): 547 – 553.
Value of LDL Particle Number and Size as Predictors of CAD in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study: Summary • In the large cohort of apparently healthy men and women, LDL-P and non-HDL-C were more closely associated than LDL cholesterol with the occurrence of future CAD. • After adjustment for HDL-C and triglycerides, LDL-P was no longer more predictive than LDL-C. Clinical Trial Results. org El Harchaoui et al. JACC. 2007 Feb 6; 49 (5): 547 – 553.
Value of LDL Particle Number and Size as Predictors of CAD in Apparently Healthy Men and Women: The EPIC-Norfolk Prospective Population Study: Summary • These findings do not support routine use of LDL-P in CAD risk assessment strategies in primary prevention strategies. • However, recognition that patients with low HDL-C and/or high triglycerides often have elevated numbers of LDL particles without having elevated LDL-C may enable their LDL-related CAD risk to be managed more effectively. Clinical Trial Results. org El Harchaoui et al. JACC. 2007 Feb 6; 49 (5): 547 – 553.
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