Apolipoprotein B, Triglyceride-Rich Lipoproteins, and Risk of Cardiovascular Events in Persons with CKD.
Aged
Anticholesteremic Agents
/ therapeutic use
Apolipoprotein B-100
/ blood
Biomarkers
/ blood
Cardiovascular Diseases
/ diagnosis
Dyslipidemias
/ blood
Ezetimibe, Simvastatin Drug Combination
/ therapeutic use
Female
Glomerular Filtration Rate
Heart Disease Risk Factors
Humans
Kidney
/ physiopathology
Lipoproteins
/ blood
Male
Middle Aged
Prognosis
Randomized Controlled Trials as Topic
Renal Dialysis
Renal Insufficiency, Chronic
/ complications
Risk Assessment
Time Factors
Triglycerides
/ blood
HDL cholesterol
LDL cholesterol
apolipoproteins
cardiovascular disease
cardiovascular diseases
cholesterol
chronic kidney disease
chronic renal insufficiency
demography
follow-up studies
glomerular filtration rate
humans
lipids
lipoprotein cholesterol
lipoprotein triglyceride
lipoproteins
low density lipoprotein triglyceride
renal dialysis
risk factors
triglycerides
Journal
Clinical journal of the American Society of Nephrology : CJASN
ISSN: 1555-905X
Titre abrégé: Clin J Am Soc Nephrol
Pays: United States
ID NLM: 101271570
Informations de publication
Date de publication:
07 01 2020
07 01 2020
Historique:
received:
22
06
2019
accepted:
18
10
2019
pubmed:
14
12
2019
medline:
1
6
2021
entrez:
14
12
2019
Statut:
ppublish
Résumé
Triglyceride-rich lipoproteins may contribute to the high cardiovascular risk of patients with CKD. This study evaluated associations of apo-B and markers of triglyceride-rich lipoproteins with cardiovascular events in people with CKD. Analyses were conducted in 9270 participants with CKD in the Study of Heart and Renal Protection (SHARP): 6245 not on dialysis (mean eGFR 26.5 ml/min per 1.73 m During a median follow-up of 4.9 years (interquartile range, 4.0-5.5 years), 1406 participants experienced at least one atherosclerotic vascular event. In multivariable adjusted models, positive associations with atherosclerotic vascular events were observed for apo-B (HR per 1 SD, 1.19; 95% confidence interval, 1.12 to 1.27), triglycerides (1.06; 1.00 to 1.13), the ratio of triglyceride to HDL cholesterol (1.10; 1.03 to 1.18), and triglyceride-rich lipoprotein cholesterol (1.14; 1.05 to 1.25). By contrast, inverse associations with nonatherosclerotic vascular events were observed for each of these lipid markers: apo-B (HR per 1 SD, 0.92; 0.85 to 0.98), triglycerides (0.86; 0.81 to 0.92), the ratio of triglyceride to HDL cholesterol (0.88; 0.82 to 0.94), and triglyceride-rich lipoprotein cholesterol (0.85; 0.77 to 0.94). Higher apo-B, triglycerides, ratio of triglyceride to HDL cholesterol, and triglyceride-rich lipoprotein cholesterol concentrations were associated with increased risk of atherosclerotic vascular events in CKD. Reducing triglyceride-rich lipoproteins using novel therapeutic agents could potentially lower the risk of atherosclerotic cardiovascular disease risk in the CKD population.
Sections du résumé
BACKGROUND AND OBJECTIVES
Triglyceride-rich lipoproteins may contribute to the high cardiovascular risk of patients with CKD. This study evaluated associations of apo-B and markers of triglyceride-rich lipoproteins with cardiovascular events in people with CKD.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
Analyses were conducted in 9270 participants with CKD in the Study of Heart and Renal Protection (SHARP): 6245 not on dialysis (mean eGFR 26.5 ml/min per 1.73 m
RESULTS
During a median follow-up of 4.9 years (interquartile range, 4.0-5.5 years), 1406 participants experienced at least one atherosclerotic vascular event. In multivariable adjusted models, positive associations with atherosclerotic vascular events were observed for apo-B (HR per 1 SD, 1.19; 95% confidence interval, 1.12 to 1.27), triglycerides (1.06; 1.00 to 1.13), the ratio of triglyceride to HDL cholesterol (1.10; 1.03 to 1.18), and triglyceride-rich lipoprotein cholesterol (1.14; 1.05 to 1.25). By contrast, inverse associations with nonatherosclerotic vascular events were observed for each of these lipid markers: apo-B (HR per 1 SD, 0.92; 0.85 to 0.98), triglycerides (0.86; 0.81 to 0.92), the ratio of triglyceride to HDL cholesterol (0.88; 0.82 to 0.94), and triglyceride-rich lipoprotein cholesterol (0.85; 0.77 to 0.94).
CONCLUSIONS
Higher apo-B, triglycerides, ratio of triglyceride to HDL cholesterol, and triglyceride-rich lipoprotein cholesterol concentrations were associated with increased risk of atherosclerotic vascular events in CKD. Reducing triglyceride-rich lipoproteins using novel therapeutic agents could potentially lower the risk of atherosclerotic cardiovascular disease risk in the CKD population.
Identifiants
pubmed: 31831577
pii: 01277230-202001000-00010
doi: 10.2215/CJN.07320619
pmc: PMC6946066
doi:
Substances chimiques
APOB protein, human
0
Anticholesteremic Agents
0
Apolipoprotein B-100
0
Biomarkers
0
Ezetimibe, Simvastatin Drug Combination
0
Lipoproteins
0
Triglycerides
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
47-60Subventions
Organisme : Medical Research Council
ID : MC_UU_00017/3
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U137686849
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12026/6
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00017/4
Pays : United Kingdom
Organisme : British Heart Foundation
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R007764/1
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 by the American Society of Nephrology.
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