Baseline very low-density lipoprotein cholesterol is associated with the magnitude of triglyceride lowering on statins, fenofibric acid, or their combination in patients with mixed dyslipidemia

Abhinav Sharma, Parag H. Joshi, Sarah Rinehart, Kamlesh M. Thakker, Aditya Lele, Szilard Voros

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Fibric acid derivatives like fenofibric acid (FA) decrease hepatic production of very low-density lipoprotein (VLDL)-associated triglycerides (TG). Hepatic VLDL production can be estimated from VLDL-associated cholesterol (VLDL-C). We assessed if the degree of TG reduction observed with FA, statins, or their combination is associated with baseline VLDL-C. Overall, 2,715 patients with mixed dyslipidemia in three randomized, controlled studies were assigned to one of six treatment strategies: FA, low-dose statin (LDS), FA∈+∈LDS, moderate-dose statin (MDS), FA∈+∈MDS, and high-dose statin (HDS). Patients were dichotomized into low- or high-baseline VLDL-C groups. Pooled data were used to compare the degree of TG reduction in patients with low- vs. high-baseline VLDL-C for each treatment arm, using unpaired, two-sided t test. Additionally, the association between baseline VLDL-C level and percentage TG reduction from baseline was evaluated by linear regression. Diagnostic performance of baseline VLDL-C levels in predicting 5, 10, 15, and 20 % TG reduction was assessed by receiver operating characteristics (ROC) analysis. In all treatment groups, following 12 weeks of therapy, a significantly greater percent change from baseline in TG was observed in the high-baseline VLDL-C group as compared with the low-baseline VLDL-C group. Linear regression analysis indicated that approximately 6 to 13 % of the decrease in TG could be explained by baseline VLDL-C. ROC-derived cut points for baseline VLDL-C were obtained for 5, 10, 15, and 20 % TG reduction. Baseline VLDL-C levels are associated with the degree of TG lowering using FA, statins, or their combination, thereof.

Original languageEnglish (US)
Pages (from-to)465-474
Number of pages10
JournalJournal of Cardiovascular Translational Research
Volume7
Issue number4
DOIs
StatePublished - Jan 1 2014

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
VLDL Cholesterol
VLDL Lipoproteins
Dyslipidemias
Triglycerides
ROC Curve
Linear Models
fenofibric acid
Fibric Acids
Liver
Therapeutics
Regression Analysis

Keywords

  • Dyslipidemia
  • Fenofibrates
  • Statins
  • Triglycerides
  • VLDL-cholesterol

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmaceutical Science
  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)

Cite this

Baseline very low-density lipoprotein cholesterol is associated with the magnitude of triglyceride lowering on statins, fenofibric acid, or their combination in patients with mixed dyslipidemia. / Sharma, Abhinav; Joshi, Parag H.; Rinehart, Sarah; Thakker, Kamlesh M.; Lele, Aditya; Voros, Szilard.

In: Journal of Cardiovascular Translational Research, Vol. 7, No. 4, 01.01.2014, p. 465-474.

Research output: Contribution to journalArticle

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abstract = "Fibric acid derivatives like fenofibric acid (FA) decrease hepatic production of very low-density lipoprotein (VLDL)-associated triglycerides (TG). Hepatic VLDL production can be estimated from VLDL-associated cholesterol (VLDL-C). We assessed if the degree of TG reduction observed with FA, statins, or their combination is associated with baseline VLDL-C. Overall, 2,715 patients with mixed dyslipidemia in three randomized, controlled studies were assigned to one of six treatment strategies: FA, low-dose statin (LDS), FA∈+∈LDS, moderate-dose statin (MDS), FA∈+∈MDS, and high-dose statin (HDS). Patients were dichotomized into low- or high-baseline VLDL-C groups. Pooled data were used to compare the degree of TG reduction in patients with low- vs. high-baseline VLDL-C for each treatment arm, using unpaired, two-sided t test. Additionally, the association between baseline VLDL-C level and percentage TG reduction from baseline was evaluated by linear regression. Diagnostic performance of baseline VLDL-C levels in predicting 5, 10, 15, and 20 {\%} TG reduction was assessed by receiver operating characteristics (ROC) analysis. In all treatment groups, following 12 weeks of therapy, a significantly greater percent change from baseline in TG was observed in the high-baseline VLDL-C group as compared with the low-baseline VLDL-C group. Linear regression analysis indicated that approximately 6 to 13 {\%} of the decrease in TG could be explained by baseline VLDL-C. ROC-derived cut points for baseline VLDL-C were obtained for 5, 10, 15, and 20 {\%} TG reduction. Baseline VLDL-C levels are associated with the degree of TG lowering using FA, statins, or their combination, thereof.",
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