title: Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis.
abstract: BACKGROUND
  The associations of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB) levels with the risk of cardiovascular events among patients treated with statin therapy have not been reliably documented.
  
  
  OBJECTIVE
  To evaluate the relative strength of the associations of LDL-C, non-HDL-C, and apoB with cardiovascular risk among patients treated with statin therapy.
  
  
  METHODS
  Meta-analysis of individual patient data from randomized controlled statin trials in which conventional lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up.
  
  
  METHODS
  Relevant trials were identified by a literature search updated through December 31, 2011. Investigators were contacted and individual patient data were requested and obtained for 62,154 patients enrolled in 8 trials published between 1994 and 2008.
  
  
  METHODS
  Hazard ratios (HRs) and corresponding 95% CIs for risk of major cardiovascular events adjusted for established risk factors by 1-SD increase in LDL-C, non-HDL-C, and apoB.
  
  
  RESULTS
  Among 38,153 patients allocated to statin therapy, 158 fatal myocardial infarctions, 1678 nonfatal myocardial infarctions, 615 fatal events from other coronary artery disease, 2806 hospitalizations for unstable angina, and 1029 fatal or nonfatal strokes occurred during follow-up. The adjusted HRs for major cardiovascular events per 1-SD increase were 1.13 (95% CI, 1.10-1.17) for LDL-C, 1.16 (95% CI, 1.12-1.19) for non-HDL-C, and 1.14 (95% CI, 1.11-1.18) for apoB. These HRs were significantly higher for non-HDL-C than LDL-C (P = .002) and apoB (P = .02). There was no significant difference between apoB and LDL-C (P = .21).
  
  
  CONCLUSIONS
  Among statin-treated patients, on-treatment levels of LDL-C, non-HDL-C, and apoB were each associated with risk of future major cardiovascular events, but the strength of this association was greater for non-HDL-C than for LDL-C and apoB.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: S Matthijs
authors.initials: SM
authors.lastname: Boekholdt
authors.forename: Benoit J
authors.initials: BJ
authors.lastname: Arsenault
authors.forename: Samia
authors.initials: S
authors.lastname: Mora
authors.forename: Terje R
authors.initials: TR
authors.lastname: Pedersen
authors.forename: John C
authors.initials: JC
authors.lastname: LaRosa
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Nestel
authors.forename: R John
authors.initials: RJ
authors.lastname: Simes
authors.forename: Paul
authors.initials: P
authors.lastname: Durrington
authors.forename: Graham A
authors.initials: GA
authors.lastname: Hitman
authors.forename: K M A
authors.initials: KM
authors.lastname: Welch
authors.forename: David A
authors.initials: DA
authors.lastname: DeMicco
authors.forename: Aeilko H
authors.initials: AH
authors.lastname: Zwinderman
authors.forename: Michael B
authors.initials: MB
authors.lastname: Clearfield
authors.forename: John R
authors.initials: JR
authors.lastname: Downs
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tonkin
authors.forename: Helen M
authors.initials: HM
authors.lastname: Colhoun
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Gotto
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ridker
authors.forename: John J P
authors.initials: JJ
authors.lastname: Kastelein
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001055:Apolipoproteins B / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D000924:Anticholesteremic Agents; D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol