The predictive role of atherogenic dyslipidemia in subjects with non-coronary atherosclerosis.
BACKGROUND
Recent findings have suggested that subjects with non-coronary atherosclerosis may show elevated prevalence of atherogenic dyslipidemia, including higher triglyceride levels, reduced HDL-cholesterol concentrations and increased levels of small, dense low-density lipoproteins (LDL). These three lipid abnormalities constitute the so-called "atherogenic-lipoprotein-phenotype" (ALP) but its predictive role in these patients still remains to be established.


METHODS
We performed a 2-year follow-up study to assess clinical and biochemical predictors of cardiovascular events in 44 male patients (64+/-5 years, BMI: 27+/-3), 26 with peripheral arterial disease and 18 with abdominal aortic aneurysm. Beyond traditional cardiovascular risk factors, we measured LDL size and subclasses by gradient gel electrophoresis.


RESULTS
Clinical events were registered in the 43% of patients. At univariate analysis we found that patients with events had increased prevalence of hypertension (p=.0098), diabetes (p=.0089), family history of cardiovascular diseases (p=.0089), of elevated small, dense LDL (p=.0222) and ALP (p=.0224). At multivariate analysis (including all clinical and laboratory variables) we found the following independent predictors of events: hypertension (OR 8.9, p=.0347), diabetes (OR 9.4, p=.0270), elevated small, dense LDL (OR 6.9, p=.0488) and ALP (OR 8.7, p=.0497).


CONCLUSIONS
This is the first study that evaluated the predictive role of ALP beyond traditional cardiovascular risk factors in patients with peripheral arterial disease or abdominal aortic aneurysm. We confirmed that hypertension and diabetes are strong predictors of cardiovascular events in these subjects but ALP seems to be an independent predictor too. Yet, the therapeutical consequences of these findings need to be tested by future studies.
Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Zurich, Switzerland.
Kaspar
K
Berneis
Manfredi
M
Rizzo
Giatgen A
GA
Spinas
Gabriele
G
Di Lorenzo
Gaetana
G
Di Fede
Ilenia
I
Pepe
Vincenzo
V
Pernice
Giovam Battista
GB
Rini
D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000150:complications / Q000235:genetics; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000235:genetics; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000097:blood / Q000150:complications* / Q000235:genetics; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000150:complications / Q000235:genetics; D010641:Phenotype; D012307:Risk Factors
D008078:Cholesterol, LDL