Atherogene dyslipidemie frequent bij stabiele CAD

A significant proportion of patients with coronary artery disease (CAD) could benefit from efforts to increase their high-density lipoprotein (HDL) cholesterol levels and reduce triglycerides, researchers say.
 

Their cross-sectional study indicated that more than half of all patients with stable coronary disease may have low HDL cholesterol or raised triglycerides, regardless of whether or not they are taking statins, with one in eight having both conditions simultaneously.
 

Atherogenic dyslipidemia is characterized by high triglycerides and low HDL cholesterol, frequently associated with elevated apolipoprotein B and small, dense low-density lipoprotein (LDL) particles, explain C Lahoz (Hospital Carlos III, Madrid, Spain) and co-workers.
 

They investigated its prevalence in 7823 Spanish individuals admitted to hospital for a coronary event or coronary revascularization between 6 months and 10 years previously.Atherogenic dyslipidemia was considered to be the simultaneous presence of low HDL cholesterol, of less than 1.03 mmol/l (40 mg/dl) in men or 1.29 mmol/l (50 mg/dl) in women, and elevated triglycerides of at least 1.7 mmol/l (150 mg/dl).The mean age of participants was 65.3 years, 73.6% were men, and 80.3% were receiving treatment with statins.Low HDL cholesterol was observed in 26.3% of the patients studied, and elevated triglycerides in 39.7%, with 13.0% defined as having atherogenic dyslipidemia.The occurrence of atherogenic dyslipidemia was particularly high among individuals meeting the criteria for the metabolic syndrome, at 30.9%.
 

Factors independently associated with atherogenic dyslipidemia included female gender, having had a non-ST elevation acute coronary syndrome or coronary revascularization, atrial fibrillation, and higher body mass index, LDL cholesterol, systolic blood pressure and blood glucose levels.
 

In contrast, age and glomerular filtration rate were significantly and inversely associated with atherogenic dyslipidemia, the authors note in the journal Nutrition, Metabolism, and Cardiovascular Diseases.
 

They conclude: "A large percentage of patients with coronary disease have less than ideal concentrations of HDL-cholesterol and triglycerides, which have been associated with an increased risk of new events"."Intervention aimed at these factors may prove to be a useful tool in the reduction of the residual vascular risk in this population."