Relations of Change in Plasma Levels of LDL‐C, Non‐HDL‐C and apoB With Risk Reduction From Statin Therapy: A Meta‐Analysis of Randomized Trials
View/ Open
Author
Thanassoulis, George
Williams, Ken
Ye, Keying
Brook, Robert
Couture, Patrick
de Graaf, Jacqueline
Furberg, Curt D.
Sniderman, Allan
Published Version
https://doi.org/10.1161/JAHA.113.000759Metadata
Show full item recordCitation
Thanassoulis, George, Ken Williams, Keying Ye, Robert Brook, Patrick Couture, Patrick R. Lawler, Jacqueline de Graaf, Curt D. Furberg, and Allan Sniderman. 2014. “Relations of Change in Plasma Levels of LDL‐C, Non‐HDL‐C and apoB With Risk Reduction From Statin Therapy: A Meta‐Analysis of Randomized Trials.” Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 3 (2): e000759. doi:10.1161/JAHA.113.000759. http://dx.doi.org/10.1161/JAHA.113.000759.Abstract
Background: Identifying the best markers to judge the adequacy of lipid‐lowering treatment is increasingly important for coronary heart disease (CHD) prevention given that several novel, potent lipid‐lowering therapies are in development. Reductions in LDL‐C, non‐HDL‐C, or apoB can all be used but which most closely relates to benefit, as defined by the reduction in events on statin treatment, is not established. Methods and Results: We performed a random‐effects frequentist and Bayesian meta‐analysis of 7 placebo‐controlled statin trials in which LDL‐C, non‐HDL‐C, and apoB values were available at baseline and at 1‐year follow‐up. Summary level data for change in LDL‐C, non‐HDL‐C, and apoB were related to the relative risk reduction from statin therapy in each trial. In frequentist meta‐analyses, the mean CHD risk reduction (95% CI) per standard deviation decrease in each marker across these 7 trials were 20.1% (15.6%, 24.3%) for LDL‐C; 20.0% (15.2%, 24.7%) for non‐HDL‐C; and 24.4% (19.2%, 29.2%) for apoB. Compared within each trial, risk reduction per change in apoB averaged 21.6% (12.0%, 31.2%) greater than changes in LDL‐C (P<0.001) and 24.3% (22.4%, 26.2%) greater than changes in non‐HDL‐C (P<0.001). Similarly, in Bayesian meta‐analyses using various prior distributions, Bayes factors (BFs) favored reduction in apoB as more closely related to risk reduction from statins compared with LDL‐C or non‐HDL‐C (BFs ranging from 484 to 2380). Conclusions: Using both a frequentist and Bayesian approach, relative risk reduction across 7 major placebo‐controlled statin trials was more closely related to reductions in apoB than to reductions in either non‐HDL‐C or LDL‐C.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187506/pdf/Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACitable link to this page
http://nrs.harvard.edu/urn-3:HUL.InstRepos:13454653
Collections
- HMS Scholarly Articles [17922]
- SPH Scholarly Articles [6362]
Contact administrator regarding this item (to report mistakes or request changes)