Effect of Novel Stratified Lipid Risk by "LDL-Window" and Flow-Mediated Dilation on the Prognosis of Coronary Artery Disease Using the FMD-J Study A Data

Shichiro Abe, Yasuo Haruyama, Gen Kobashi, Shigeru Toyoda, Teruo Inoue, Hirofumi Tomiyama, Tomoko Ishizu, Takahide Kohro, Yukihito Higashi, Bonpei Takase, Toru Suzuki, Shinichiro Ueda, Tsutomu Yamazaki, Tomoo Furumoto, Kazuomi Kario, Shinji Koba, Yasuhiko Takemoto, Takuzo Hano, Masataka Sata, Yutaka IshibashiKoichi Node, Koji Maemura, Yusuke Ohya, Taiji Furukawa, Hiroshi Ito, Akira Yamashina

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Elevated levels of triglyceride (TG) and non-high-density lipoprotein cholesterol (non-HDL-C) are regarded as a residual lipid risk in low-density lipoprotein cholesterol (LDL-C)-lowering therapy. This study investigated the association between lipid risk stratified by TG and non-HDL-C and the prognosis of patients with coronary artery disease (CAD), and the association between stratified lipid risk and flow-mediated dilatation (FMD) index. Methods and Results: The 624 CAD patients enrolled in flow-mediated dilation (FMD)-J study A were divided into 4 groups: low-risk group (n=413) with TG <150 mg/dL and non-HDL-C <170 mg/dL; hyper-TG group (n=180) with TG ≥150 mg/dL and non-HDL-C <170 mg/dL; hyper-non-HDL group (n=12) with TG <150 mg/dL and non-HDL-C ≥170 mg/dL; and high-risk group (n=19) with TG ≥150 mg/dL and non-HDL-C ≥170 mg/dL. Comparison of the groups showed the cumulative incidence of a 3-point major adverse cardiovascular event (MACE) was different and highest in the high-risk group in all the patients (P=0.009), and in patients with a FMD index ≥7.0% (P=0.021), but not in those with a FMD index <7.0%. Multivariable regression analysis showed that high lipid risk (P=0.019) and FMD <7.0% (P=0.040) were independently correlated with the incidence of a 3-point MACE. Conclusions: Novel stratification of lipid risk, simply using TG and non-HDL-C levels, combined with FMD measurement, is useful for predicting cardiovascular outcomes in patients with CAD.

Original languageEnglish
Pages (from-to)1444-1454
Number of pages11
JournalCirculation Journal
Volume86
Issue number9
DOIs
Publication statusPublished - 2022

Keywords

  • Coronary artery disease
  • Flow-mediated dilation
  • Lipid risk stratification
  • Non-high-density lipoprotein cholesterol
  • Triglyceride

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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