Prediction of cardiovascular events in statin-treated stable coronary patients by lipid and nonlipid biomarkers

Benoit J. Arsenault, Philip Barter, David A. Demicco, Weihang Bao, Gregory M. Preston, John C. Larosa, Scott M Grundy, Prakash Deedwania, Heiner Greten, Nanette K. Wenger, James Shepherd, David D. Waters, John J P Kastelein

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives The aim of this study was to investigate the relationship between lipid and nonlipid biomarker levels achieved during statin therapy and the incidence of major cardiovascular events (MCVEs) in patients with stable coronary heart disease (CHD). Background Several plasma nonlipid biomarkers have been shown to predict MCVEs in population studies. Methods This is a nested case-control study in the TNT (Treating to New Targets) study population, a randomized trial that compared the efficacy of high- (80 mg) versus low-dose (10 mg) atorvastatin for the secondary prevention of CHD. Fasting plasma levels of standard lipids and of 18 nonlipid biomarkers were obtained after an 8-week run-in period on atorvastatin 10 mg and again 1 year after being randomized to 10 or 80 mg atorvastatin in 507 patients who experienced MCVEs during the 4.9 years of study follow-up and in 1,020 control subjects. An MCVE was defined as CHD death; nonfatal, nonprocedure-related myocardial infarction; resuscitated cardiac arrest; or fatal or nonfatal stroke. Results Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides were all predictive of recurrent MCVEs (p ≤ 0.009). Concentrations of many of the 18 nonlipid biomarkers were lowered by atorvastatin therapy (independent of dose). However, almost none of the nonlipid biomarker levels, whether measured after the 8-week run-in period or after 1 year of treatment with 10 or 80 mg atorvastatin, were predictive of recurrent MCVEs. Conclusions In patients with stable CHD, atorvastatin improved plasma levels of an expanded panel of nonlipid biomarkers. However, independently of atorvastatin dose, the achieved levels of the vast majority of nonlipid biomarkers did not predict MCVEs. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691)

Original languageEnglish (US)
Pages (from-to)63-69
Number of pages7
JournalJournal of the American College of Cardiology
Volume57
Issue number1
DOIs
StatePublished - Dec 28 2010

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Biomarkers
Lipids
Coronary Disease
Health Services Needs and Demand
Secondary Prevention
Atorvastatin Calcium
Heart Arrest
LDL Cholesterol
HDL Cholesterol
Case-Control Studies
Fasting
Therapeutics
Stroke
Myocardial Infarction
Incidence
Population

Keywords

  • biomarkers
  • coronary heart disease
  • inflammation
  • lipids
  • oxidative stress
  • statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Arsenault, B. J., Barter, P., Demicco, D. A., Bao, W., Preston, G. M., Larosa, J. C., ... Kastelein, J. J. P. (2010). Prediction of cardiovascular events in statin-treated stable coronary patients by lipid and nonlipid biomarkers. Journal of the American College of Cardiology, 57(1), 63-69. https://doi.org/10.1016/j.jacc.2010.06.052

Prediction of cardiovascular events in statin-treated stable coronary patients by lipid and nonlipid biomarkers. / Arsenault, Benoit J.; Barter, Philip; Demicco, David A.; Bao, Weihang; Preston, Gregory M.; Larosa, John C.; Grundy, Scott M; Deedwania, Prakash; Greten, Heiner; Wenger, Nanette K.; Shepherd, James; Waters, David D.; Kastelein, John J P.

In: Journal of the American College of Cardiology, Vol. 57, No. 1, 28.12.2010, p. 63-69.

Research output: Contribution to journalArticle

Arsenault, BJ, Barter, P, Demicco, DA, Bao, W, Preston, GM, Larosa, JC, Grundy, SM, Deedwania, P, Greten, H, Wenger, NK, Shepherd, J, Waters, DD & Kastelein, JJP 2010, 'Prediction of cardiovascular events in statin-treated stable coronary patients by lipid and nonlipid biomarkers', Journal of the American College of Cardiology, vol. 57, no. 1, pp. 63-69. https://doi.org/10.1016/j.jacc.2010.06.052
Arsenault, Benoit J. ; Barter, Philip ; Demicco, David A. ; Bao, Weihang ; Preston, Gregory M. ; Larosa, John C. ; Grundy, Scott M ; Deedwania, Prakash ; Greten, Heiner ; Wenger, Nanette K. ; Shepherd, James ; Waters, David D. ; Kastelein, John J P. / Prediction of cardiovascular events in statin-treated stable coronary patients by lipid and nonlipid biomarkers. In: Journal of the American College of Cardiology. 2010 ; Vol. 57, No. 1. pp. 63-69.
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AU - Barter, Philip

AU - Demicco, David A.

AU - Bao, Weihang

AU - Preston, Gregory M.

AU - Larosa, John C.

AU - Grundy, Scott M

AU - Deedwania, Prakash

AU - Greten, Heiner

AU - Wenger, Nanette K.

AU - Shepherd, James

AU - Waters, David D.

AU - Kastelein, John J P

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N2 - Objectives The aim of this study was to investigate the relationship between lipid and nonlipid biomarker levels achieved during statin therapy and the incidence of major cardiovascular events (MCVEs) in patients with stable coronary heart disease (CHD). Background Several plasma nonlipid biomarkers have been shown to predict MCVEs in population studies. Methods This is a nested case-control study in the TNT (Treating to New Targets) study population, a randomized trial that compared the efficacy of high- (80 mg) versus low-dose (10 mg) atorvastatin for the secondary prevention of CHD. Fasting plasma levels of standard lipids and of 18 nonlipid biomarkers were obtained after an 8-week run-in period on atorvastatin 10 mg and again 1 year after being randomized to 10 or 80 mg atorvastatin in 507 patients who experienced MCVEs during the 4.9 years of study follow-up and in 1,020 control subjects. An MCVE was defined as CHD death; nonfatal, nonprocedure-related myocardial infarction; resuscitated cardiac arrest; or fatal or nonfatal stroke. Results Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides were all predictive of recurrent MCVEs (p ≤ 0.009). Concentrations of many of the 18 nonlipid biomarkers were lowered by atorvastatin therapy (independent of dose). However, almost none of the nonlipid biomarker levels, whether measured after the 8-week run-in period or after 1 year of treatment with 10 or 80 mg atorvastatin, were predictive of recurrent MCVEs. Conclusions In patients with stable CHD, atorvastatin improved plasma levels of an expanded panel of nonlipid biomarkers. However, independently of atorvastatin dose, the achieved levels of the vast majority of nonlipid biomarkers did not predict MCVEs. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691)

AB - Objectives The aim of this study was to investigate the relationship between lipid and nonlipid biomarker levels achieved during statin therapy and the incidence of major cardiovascular events (MCVEs) in patients with stable coronary heart disease (CHD). Background Several plasma nonlipid biomarkers have been shown to predict MCVEs in population studies. Methods This is a nested case-control study in the TNT (Treating to New Targets) study population, a randomized trial that compared the efficacy of high- (80 mg) versus low-dose (10 mg) atorvastatin for the secondary prevention of CHD. Fasting plasma levels of standard lipids and of 18 nonlipid biomarkers were obtained after an 8-week run-in period on atorvastatin 10 mg and again 1 year after being randomized to 10 or 80 mg atorvastatin in 507 patients who experienced MCVEs during the 4.9 years of study follow-up and in 1,020 control subjects. An MCVE was defined as CHD death; nonfatal, nonprocedure-related myocardial infarction; resuscitated cardiac arrest; or fatal or nonfatal stroke. Results Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides were all predictive of recurrent MCVEs (p ≤ 0.009). Concentrations of many of the 18 nonlipid biomarkers were lowered by atorvastatin therapy (independent of dose). However, almost none of the nonlipid biomarker levels, whether measured after the 8-week run-in period or after 1 year of treatment with 10 or 80 mg atorvastatin, were predictive of recurrent MCVEs. Conclusions In patients with stable CHD, atorvastatin improved plasma levels of an expanded panel of nonlipid biomarkers. However, independently of atorvastatin dose, the achieved levels of the vast majority of nonlipid biomarkers did not predict MCVEs. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691)

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