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首页> 外文期刊>The American Journal of Cardiology >Relation of clinical benefit of raising high-density lipoprotein cholesterol to serum levels of low-density lipoprotein cholesterol in patients with coronary heart disease (from the Bezafibrate Infarction Prevention Trial).
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Relation of clinical benefit of raising high-density lipoprotein cholesterol to serum levels of low-density lipoprotein cholesterol in patients with coronary heart disease (from the Bezafibrate Infarction Prevention Trial).

机译：在患有冠心病的患者中提高高密度脂蛋白胆固醇的临床获益与低密度脂蛋白胆固醇的血清水平之间的关系（来自Bezafibrate梗塞预防试验）。

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摘要

Low high-density lipoprotein (HDL) cholesterol is a strong independent predictor of cardiovascular risk. The present study was designed to assess the relation between the clinical response to HDL cholesterol modification and serum levels of low-density lipoprotein (LDL) cholesterol in patients with coronary artery disease (CAD). The risk for a major cardiac event (defined as nonfatal myocardial infarction or cardiac death) during a median 7.9-year follow-up period in 3,020 patients with CAD enrolled in the Bezafibrate Infarction Prevention (BIP) trial was related to changes in lipid levels during the study. Baseline LDL cholesterol levels were categorized according to National Cholesterol Education Program Adult Treatment Panel III criteria. Multivariate analysis demonstrated that the benefit of HDL cholesterol increase was most pronounced in patients with low baseline LDL cholesterol (or=160 mg/dl; hazard ratio 0.94, 95% confidence interval 0.75 to 1.17, p = 0.14). A similar relation was shown for risk reduction-associated triglyceride decrements, whereas the benefit of LDL cholesterol reduction was more pronounced in patients with baseline LDL cholesterol >or=130 mg/dl. In conclusion, these data suggest that the clinical response to HDL cholesterol and triglyceride modification is inversely related to baseline LDL cholesterol levels. Thus, combined assessment of baseline and follow-up lipid levels to direct therapeutic goals in patients with CAD may provide incremental prognostic information to secondary prevention that is based solely on LDL cholesterol modification.
机译：低高密度脂蛋白（HDL）胆固醇是心血管风险的强烈独立预测因子。本研究旨在评估冠心病（CAD）患者对HDL胆固醇修饰的临床反应与血清低密度脂蛋白（LDL）胆固醇水平之间的关系。在接受Bezafibrate梗死预防（BIP）试验的3,020名CAD患者中位数7.9年的随访期间，发生重大心脏事件（定义为非致命性心肌梗塞或心脏死亡）的风险与脂质水平变化有关。研究。基线低密度脂蛋白胆固醇水平根据美国国家胆固醇教育计划成人治疗小组III标准进行分类。多变量分析表明，低基线LDL胆固醇（<或= 129 mg / dl; HDL胆固醇每升高5 mg / dl，风险降低29％，p = 0.02）时，HDL胆固醇增加的益处最为明显。具有低密度脂蛋白胆固醇（130至159 mg / dl;高密度脂蛋白胆固醇每增加5 mg / dl降低13％的风险，p = 0.03），而高低密度脂蛋白胆固醇（> = 160 mg / dl）的患者无统计学意义比率0.94，95％置信区间0.75至1.17，p = 0.14）。风险降低相关的甘油三酯降低显示出相似的关系，而基线LDL胆固醇>或= 130 mg / dl的患者，LDL胆固醇降低的益处更为明显。总之，这些数据表明，对HDL胆固醇和甘油三酸酯修饰的临床反应与基线LDL胆固醇水平成反比。因此，对基线和后续血脂水平的联合评估以指导CAD患者的治疗目标，可以为仅基于LDL胆固醇修饰的二级预防提供更多的预后信息。

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