title: [Magnitude and characteristics of residual lipid risk in patients with a history of coronary revascularization: the ICP-bypass study].
abstract: OBJECTIVE
  Residual lipid risk has been defined as the excess of cardiovascular events observed in patients with adequate control of low-density lipoprotein cholesterol and has been mainly attributed to high-density lipoprotein cholesterol and triglycerides. The aim of our study was to describe the clinical features and the magnitude and characteristics associated with residual lipid risk in patients with a history of coronary revascularization.
  
  
  METHODS
  Multicenter, observational, cross-sectional study of patients with a history of coronary revascularization. Residual lipid risk was defined as the presence of high-density lipoprotein cholesterol <40 mg/dL and/or triglycerides >150 mg/dL in patients with low-density lipoprotein cholesterol <100 mg/dL.
  
  
  RESULTS
  We included 2292 patients with a mean age of 65.5 (12.4) years; 94.1% were receiving no statin therapy and 4.8% no lipid therapy. Statin-only therapy (74%) was the most common strategy, followed by combination with ezetimibe (17%). The prevalence of high-density lipoprotein cholesterol <40 mg/dL was 35.8%, hypertriglyceridemia 38.9%, and low-density lipoprotein cholesterol >100 mg/dL 44.9%; the residual lipid risk group included 29.9% of all patients. This patient group had a similar clinical profile except for slightly lower mean age, higher incidence of diabetes, and higher proportion of men. Multivariate analysis identified positive associations of diabetes and male sex with residual lipid risk; current smoking, male sex, and fibrate therapy were associated with high-density lipoprotein cholesterol <40 mg/dL; current smoking, abdominal obesity, and fibrate therapy were associated with hypertriglyceridemia.
  
  
  CONCLUSIONS
  In daily clinical practice, almost one-third of patients with a history of coronary revascularization have low-density lipoprotein cholesterol <100 mg/dL plus low high-density lipoprotein cholesterol and/or hypertriglyceridemia, a concept known as residual lipid risk.
authors.affiliation: Servicio de Cardiología, Complejo Hospitalario Universitario Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, España. jose.Ramon.Gonzalez.Juanatey@sergas.es
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Juanatey
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero
authors.forename: Gustavo C
authors.initials: GC
authors.lastname: Vitale
authors.forename: Belén
authors.initials: B
authors.lastname: González-Timón
authors.forename: Pilar
authors.initials: P
authors.lastname: Mazón
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D001026:Coronary Artery Bypass; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012306:Risk; D013030:Spain / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D014280:Triglycerides