Relations of lipoprotein subclass levels and low-density lipoprotein size to progression of coronary artery disease in the pravastatin limitation of atherosclerosis in the coronary arteries (PLAC-I) trial
Relations of lipoprotein subclass levels and low-density lipoprotein size to progression of coronary artery disease in the pravastatin limitation of atherosclerosis in the coronary arteries (PLAC-I) trial
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DOI：
10.1016/s0002-9149(02)02427-x
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发表时间：
2002-07-15
影响因子：
2.8
通讯作者：
Freedman, DS
中科院分区：
文献类型：
--
作者：
Rosenson, RS;Otvos, JD;Freedman, DS
脂蛋白亚类测定可增强对冠状动脉疾病（CAD）风险的预测，但实验室测定方法相对费时费力，阻碍了这些信息的临床应用。在这项研究中，使用自动核磁共振技术对来自241名参与普伐他汀限制冠状动脉粥样硬化试验的参与者的冷冻血浆样本进行脂蛋白亚类分析。目的是根据3年内最小管腔直径的变化，确定这些亚类的水平是否提供了关于CAD进展的额外信息。在对种族、性别、年龄、治疗组、基线管腔直径和甘油三酯、低密度脂蛋白（LDL）胆固醇和高密度脂蛋白（HDL）胆固醇的化学测量水平进行校正后，试验期间进展的预测因子（p < 0.05）包括LDL颗粒数量升高，以及小LDL和小HDL水平。在治疗组中，CAD进展与LDL颗粒数（安慰剂）和小HDL水平（普伐他汀）最密切相关。在校正了化学测定的血脂水平和其他协变量的logistic回归模型中，安慰剂组中，LDL水平大于或等于30 mg/dl（中位数）与CAD进展风险增加9倍相关（p < 0.01）。这些结果表明，各种脂蛋白亚类的水平可以提供有用的信息，CAD风险，即使水平的传统危险因素是已知的。(C)2002年，Excerpta Medica，Inc.
\Lipoprotein subclass measurements may enhance the prediction of coronary artery disease (CAD) risk, but clinical application of such information has been hindered by the relatively laborious and time-consuming nature of laboratory measurement methods. In this study, lipoprotein subclass analyses were performed on frozen plasma samples from 241 participants in the Pravastatin Limitation of Atherosclerosis in the Coronary arteries Trial using an automated nuclear magnetic resonance technique. The objective was to determine if levels of these subclasses provided additional information on the progression of CAD, based on the change in the minimum lumen diameter, over a 3-year period. After adjustment for race, sex, age, treatment group, baseline lumen diameter, and chemically measured levels of triglycerides, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol, on-trial predictors (p < 0.05) of progression included an elevated LDL particle number, and levels of small LDL and small HDL. Within treatment groups, CAD progression was most strongly related to the LDL particle number (placebo) and levels of small HDL (pravastatin). In logistic regression models that adjusted for chemically determined lipid levels and other covariates, a small LDL level greater than or equal to30 mg/dl (median) was associated with a ninefold increased risk of CAD progression (p < 0.01) in the placebo group. These results indicate that levels of various lipoprotein subclasses may provide useful information on CAD risk even if levels of traditional risk factors are known. (C) 2002 by Excerpta Medica, Inc.