Abstract

In patients with atherosclerotic cardiovascular disease (ASCVD) under statin treatment, the influence of on-treatment level of high-density lipoprotein cholesterol (HDL-C) on cardiovascular (CV) events is controversial. Statin-treated patients were selected from the Taiwanese Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) Registry, a multicenter, observational study of adult patients with ASCVD in Taiwan. Low HDL-C was defined as < 40 mg/dL for men and < 50 mg/dL for women. The primary outcome was a composite CV events including CV death, myocardial infarction (MI), stroke or cardiac arrest with resuscitation. A total of 3731 patients (mean age 65.6 years, 75.6% men) were included. Patients with on-treatment low HDL-C (44%, mean HDL-C 34.9 ± 6.8 mg/dL) were younger and with more diabetes and higher body weight. The mean follow-up time was 2.7 years. We used restricted cubic spline curves to examine the potential non-linear association between HDL-C and adverse outcomes. Decreased HDL-C levels were associated with a significantly increased risk of CV events in women (< 49 mg/dL in women) but not in men (< 42 mg/dL in men). However, the protective effect of elevated HDL-C levels was more prominent in men than in women. In ASCVD patients with statin therapy, low on-treatment HDL-C was common in Taiwan and associated with an increased risk of CV events in women. Higher HDL-C levels provided more protective effect in men than in women.

Details

Title
Prognostic effect of high-density lipoprotein cholesterol level in patients with atherosclerotic cardiovascular disease under statin treatment
Author
Yi-Heng, Li 1 ; Wei-Kung, Tseng 2 ; Wei-Hsian, Yin 3 ; Fang-Ju, Lin 4 ; Yen-Wen, Wu 5 ; I-Chang, Hsieh 6 ; Lin Tsung-Hsien 7 ; Sheu Wayne Huey-Herng 8 ; Yeh Hung-I 9 ; Chen, Jaw-Wen 10 ; Chau-Chung, Wu 11 

 National Cheng Kung University, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255) 
 I-Shou University, Department of Medical Imaging and Radiological Sciences, Kaohsiung, Taiwan (GRID:grid.411447.3) (ISNI:0000 0004 0637 1806); E-Da Hospital, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan (GRID:grid.414686.9) (ISNI:0000 0004 1797 2180) 
 National Yang Ming University School of Medicine, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914); Cheng-Hsin General Hospital, Division of Cardiology, Heart Center, Taipei, Taiwan (GRID:grid.413846.c) (ISNI:0000 0004 0572 7890) 
 National Taiwan University, Graduate Institute of Clinical Pharmacy and School of Pharmacy, College of Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); National Taiwan University Hospital, Department of Pharmacy, Taipei, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815) 
 Far Eastern Memorial Hospital, Cardiology Division, Cardiovascular Medical Center, New Taipei City, Taiwan (GRID:grid.414746.4) (ISNI:0000 0004 0604 4784); Taipei Veterans General Hospital, Department of Medical Research and Education, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314); National Taiwan University Hospital and National Taiwan University College of Medicine, Cardiology Division, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241) 
 Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Division of Cardiology, Department of Internal Medicine, Taoyuan, Taiwan (GRID:grid.145695.a) 
 Kaohsiung Medical University Hospital, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan (GRID:grid.412027.2) (ISNI:0000 0004 0620 9374); Kaohsiung Medical University, Faculty of Medicine, College of Medicine, Kaohsiung, Taiwan (GRID:grid.412019.f) (ISNI:0000 0000 9476 5696) 
 Taichung Veterans General Hospital, Division of Endocrinology and Metabolism and Department of Medical Research, Taichung, Taiwan (GRID:grid.410764.0) (ISNI:0000 0004 0573 0731) 
 Mackay Medical College, Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, New Taipei City, Taiwan (GRID:grid.452449.a) (ISNI:0000 0004 1762 5613) 
10  National Yang Ming University, Institute of Pharmacology, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914) 
11  National Taiwan University Hospital and National Taiwan University College of Medicine, Cardiology Division, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); National Taiwan University, Graduate Institute of Medical Education and Bioethics, College of Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241) 
Publication year
2020
Publication date
2020
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2473191830
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.