+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Atherogenic dyslipidemia as evidenced by the lipid triad: prevalence and associated risk in statin-treated patients in ambulatory care

Atherogenic dyslipidemia as evidenced by the lipid triad: prevalence and associated risk in statin-treated patients in ambulatory care

Current Medical Research and Opinion 26(12): 2833-2839

The prevalence of atherogenic dyslipidaemia (AD) can be assessed using the lipid triad (low high-density lipoprotein cholesterol [HDL-C] < 35 mg/dl, high triglyceride (TG) levels (≥ 200 mg/dl) and a high total cholesterol HDL-C ratio (TC/HDL-C>5). The aim of the present analysis was (1) to describe the prevalence of the lipid triad, (2) to quantify the associated cardiovascular risk on the basis of the PROCAM score, and (3) to calculate the additional risk reduction that can be obtained by adding nicotinic acid (NA) to a pre-existing statin therapy (model based on the outcomes of a previous randomized controlled study). Descriptive post-hoc analysis of the German 4E registry in 24,500 patients receiving statins for primary cardiovascular prevention in ambulatory care. The sample comprised 24,500 patients in primary prevention, who had an overall 10-year risk of 16.2%. The prevalence of patients with lipid triad was 24.0%. The mean estimated risk reduction in the total sample (calculated on the basis of a mean LDL-C decrease by 24.3% and other lipid parameter changes) achieved after 6-week statin treatment was 46.6%, the estimated additional relative risk reduction by NA 45.1% (total effect compared to baseline about 70%). In the lipid triad group, the additional relative risk reduction by NA treatment was 42.9%. Relative treatment effects were consistent, irrespective of age and gender. Limitations of this analysis include the use of the TC/HDL-C ratio instead of the direct small dense LDL-C measurements, and the unknown variations of effect size of NA induced lipid reduction when used in combination with statins. Our model calculations indicate that the residual risk which persists after statin treatment could be substantially lowered if besides LDL-C also HDL-C and TG would be addressed, e.g. by adding NA to statin therapy. Definitive prospective studies are needed to confirm this hypothesis.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 051700360

Download citation: RISBibTeXText

PMID: 21058895

DOI: 10.1185/03007995.2010.532088

Related references

Atherogenic dyslipidemia and residual cardiovascular risk in statin-treated patients. Stroke 45(5): 1429-1436, 2014

Atherogenic dyslipidemia increases the risk of incident diabetes in statin-treated patients with impaired fasting glucose or obesity. Journal of Cardiology 74(3): 290-295, 2019

Prevalence and risk distribution of residual dyslipidemia in statin-treated patients in Greece. Angiology 63(3): 184-193, 2012

Prevalence of dyslipidemia in statin-treated patients in Canada: results of the DYSlipidemia International Study (DYSIS). Canadian Journal of Cardiology 26(9): E330-E335, 2010

Prevalence of dyslipidemia in statin-treated patients in the Baltic states (Estonia, Latvia, and Lithuania): results of the Dyslipidemia International Study (DYSIS). Medicina 50(1): 44-53, 2014

Prevalence of atherogenic dyslipidemia in primary care patients at moderate-very high risk of cardiovascular disease. Cardiovascular risk perception. Clinica e Investigacion en Arteriosclerosis 26(6): 274-284, 2015

changes in glycosylated haemoglobin levels among managed care dyslipidemia patients with type 2 diabetes treated with niacin extended-release plus statin versus other lipid therapies. Canadian Journal of Diabetes 33(3): 286-287, 2009

Prevalence of dyslipidemia and lipid goal attainment in statin-treated subjects from 3 data sources: a retrospective analysis. Journal of the American Heart Association 1(6): E001800, 2012

What is the contribution of the review of the evidence on reducing macrovascular risk in patients with atherogenic dyslipidemia? Report on consensus of experts in the importance of the combined therapy by fenofibrate with statin. Vnitrni Lekarstvi 61(11): 971-975, 2015

Risk factors associated with atherogenic dyslipidemia in the presence of optimal statin therapy. International Journal of Cardiology 248: 355-360, 2017

Prevalence and overlap of different lipid abnormalities in statin-treated patients at high cardiovascular risk in clinical practice in Germany. Clinical Research in Cardiology 99(11): 723-733, 2010

Persistent dyslipidemia in statin-treated patients: the focus on comprehensive lipid management survey in Swiss patients. Swiss Medical Weekly 141: W13200, 2011

Risk of Incident Atherosclerotic Cardiovascular DiseaseEvents by Achieved Atherogenic Lipid Levels Among62,428 Statin-Treated Individuals With Diabetes Mellitus. American Journal of Cardiology 122(5): 762-767, 2018

The DYSlipidemia International Study DYSIS-Egypt A report on the prevalence of lipid abnormalities in Egyptian patients on chronic statin treatment. The Egyptian Heart Journal 65(3): 223-232, 2013

Atherogenic dyslipidemia: prevalence and management in lipid clinics. Revista Clinica Espanola 214(9): 491-498, 2014