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Atherogenic ratios in patients with recurrent acute coronary syndrome and receiving statin therapy: Clinical usefullness as cardiovascular predictors
Abstracts / Atherosclerosis 235 (2014) e192–e301
intake of fiber, polyunsaturated fatty acids, carbons and lower intake of proteins. The vegans had significantly lower levels of serum TC, LDL-C and apoB. We did not find the significant difference in TAG and HDL-C levels between analyzed groups. Also, apoAI and apoAII levels were similar in both groups.
e209
45 - Epidemiology of dyslipidemias EAS-0439. PREVALENCE OF DYSLIPIDAEMIA: A COMPARISON OF CAUCASIAN AND SOUTH ASIAN SUBPOPULATIONS POST-ACS P.A. Patela, J.R.J. Foleya, Y. Zhenga, C. Yaua, Y. Blackburna, S. Bulugahapitiyaa a
Cardiology, Bradford Royal Infirmary, Bradford, United Kingdom
Objectives: Risk factor modification is critical in secondary prevention of acute coronary syndromes (ACS). Lipid profile is an important example and NICE guidelines advocate a rigorous approach, including introduction of a high intensity statin and lifestyle advice. Bradford has the highest density of South Asians per capita in the UK at 20.3%, predominantly originating from Pakistan. This study sought to assess for variations in prevalence of dyslipidaemia between Caucasian and Asian populations presenting with ACS. Ă
Conclusion: Findings of this study show that applied diet has an impact on lipid-related risk factors for atherosclerosis. Vegans had favorable lipid profile status, what may confirm protective role of plant-based diet in the development of atherosclerosis. 45 - Epidemiology of dyslipidemias EAS-0867. ATHEROGENIC RATIOS IN PATIENTS WITH RECURRENT ACUTE CORONARY SYNDROME AND RECEIVING STATIN THERAPY: CLINICAL USEFULLNESS AS CARDIOVASCULAR PREDICTORS J. Millana, X. Pintoa, M. Zuñigaa, A. Mangasa, A. Hernandez Mijaresa, E. Corbellaa, J.U.A.N. Pedro-Boteta a
Spanish Society of Atherosclerosis, HDL Forum, Madrid, Spain
Objectives: Cardiovascular disease management based exclusively on this lipid parameter might not be sufficient. Therapeutic guidelines, also consider other lipid factors like non HDLc, apoB, apo A-I and the total cholesterol (TC)/HDLc, some of which can be better predictors of cardiovascular risk than LDLc alone. The aim of the present study was to establish atherogenic ratios, as a marker of the atherogenicity/anti-atherogenicity balance in patients with high vascular risk receiving statin therapy, for detecting the treatable residual risk. Methods: Medical records of total of 633 ACS patients were included in the study. 478 (75.8%) had presented a myocardial infarction and 153 (24.2%) angina. A previous ACS had occurred in 43.1% of cases, and was the first episode in 56.9%. The different atherogenic indexes were analyzed. Results: 505 (79.8%) were men and 128 (20.2%) women. Patients with recurrent ACS were significantly younger, fewer were smokers, and had a higher percentage of hypertension and type 2 diabetes. Among patients with known ischemic heart disease, 187 (52.2%) were receiving lipidlowering drugs, mainly statins (50.7%) and, more rarely, fibrates (2.6%). Of those with a first ACS 21.7% were on lipid-lowering drugs: 20.1 % statins and 1.7% fibrates. Patients with recurrent ACS had similar triglyceride and HDLc levels, but significantly lower total cholesterol and LDLc concentrations compared with those presenting the first ACS. Significant differences can be found in all indexes, except for log (triglycerides)/HDLc. Patients with recurrent ACS had significantly lower non-HDLc levels, TC/HDLc and LDLc/HDLc, but higher HDLc/TC and HDLc/LDLc ratios compared with first ACS patients. Conclusion: Recurrent ACS showed a more favorable lipid profile (lower TC and LDLc and similar TG and HDLc). These findings were related to prior statin therapy. Atherogenic indexes run parallel to modifications in lipid profile and reflect the effects of lipid-lowering drugs. The unmodifiable triglyceride and HDLc concentrations account for the residual vascular risk in these patients.
Methods: Notes of consecutive patients attending a 6 week post-ACS clinic at Bradford Royal Infirmary between March 2012 and November 2013 were retrospectively reviewed for data on demographics and biochemical profiles. Results: 185 patients were included. 59% were Caucasian and 41% Asian, with a similar mean age (65.0 years [SD 13.44] vs 60.1 years [SD 13.75]). Prevalence of current smokers (37% vs 32%) and hypertension (56% vs 61%) was comparable. There was a marked discrepancy in presence of type II diabetes, 22% in Caucasians compared with 41% in Asians. 21% of Caucasians had total cholesterol > 4mM compared to 7% of Asians (OR 3.80, CI: 1.37 - 10.50, p¼0.010). 15% of Caucasians had LDL > 2mM compared with 8% of Asians (OR 2.01, CI: 0.75-5.39, p¼0.167). HDL < 1mM was present in 66% of Caucasians, versus 79% of Asians (OR 0.52, CI: 0.280.99, p¼0.043). Assessment of triglyceride levels revealed no difference (29.4% vs 32.9%, OR 0.85, CI: 0.45-1.59, p¼0.608). Compliance with statin therapy was excellent in both groups (94% vs 96%). Conclusion: This study suggests higher levels of dyslipidaemia in Caucasians compared with Asians; specifically elevated total cholesterol and lower HDL cholesterol. This trend contradicts the discrepancy in prevalence of type II diabetes between the two groups. Of reassuring note, there is excellent compliance with administration of high-dose statins. Studies utilising larger sample sizes are warranted to establish correlations further. 45 - Epidemiology of dyslipidemias EAS-0806. ETHICAL SURVEY OF HIGH CHOLESTEROL AND RISK ESTIMATION FOR FAMILIAL HYPERCHOLESTEROLEMIA IN 6320 STUDENTS OF AGES FROM 6 TO 19 YEARS A. Pereiraa, T.P. Camargoa, S.S.M. Iharaa, M.C. Eliasa, L.E.S. Almeida Pintoa, C.A. Machadoa, R.D. Santos Filhoa, S. Fernandesa, T.L.R. Martineza a
Cardiology, HCFMUSP, Sao Paulo, Brazil
Objectives: Brazilian V Guidelines (2012-Oct)Atherosclerosis Department (DA) alert to the possibility of Familial Hypercholesterolemia(FH) in children with TC> 230mg/dL . Objectives : To evaluate the TC values in students and their associations with lifestyle and socioeconomic level . Methods: Sample : 6320 students 06-19 years (55 % female) , students of public state and municipal administrations. Assay of TC i:fingertip.Samples comparable to the total universe of the studied population were assessed for lifestyle, nutritional survey(TCI ,detailed as animal proteins , carbohydrates , polyunsaturated fats , mono saturated and polyunsaturated plus fiber) with body mass index (BMII) , weight, blood pressure (BP) , socioeconomic status by income , familial aggregation and geographical housing (central , suburban– up to 20km distance and rural - from 20- to 60km) .Statistics: t test, Mann Whitney and Spearman.
intake of fiber, polyunsaturated fatty acids, carbons and lower intake of proteins. The vegans had significantly lower levels of serum TC, LDL-C and apoB. We did not find the significant difference in TAG and HDL-C levels between analyzed groups. Also, apoAI and apoAII levels were similar in both groups.
e209
45 - Epidemiology of dyslipidemias EAS-0439. PREVALENCE OF DYSLIPIDAEMIA: A COMPARISON OF CAUCASIAN AND SOUTH ASIAN SUBPOPULATIONS POST-ACS P.A. Patela, J.R.J. Foleya, Y. Zhenga, C. Yaua, Y. Blackburna, S. Bulugahapitiyaa a
Cardiology, Bradford Royal Infirmary, Bradford, United Kingdom
Objectives: Risk factor modification is critical in secondary prevention of acute coronary syndromes (ACS). Lipid profile is an important example and NICE guidelines advocate a rigorous approach, including introduction of a high intensity statin and lifestyle advice. Bradford has the highest density of South Asians per capita in the UK at 20.3%, predominantly originating from Pakistan. This study sought to assess for variations in prevalence of dyslipidaemia between Caucasian and Asian populations presenting with ACS. Ă
Conclusion: Findings of this study show that applied diet has an impact on lipid-related risk factors for atherosclerosis. Vegans had favorable lipid profile status, what may confirm protective role of plant-based diet in the development of atherosclerosis. 45 - Epidemiology of dyslipidemias EAS-0867. ATHEROGENIC RATIOS IN PATIENTS WITH RECURRENT ACUTE CORONARY SYNDROME AND RECEIVING STATIN THERAPY: CLINICAL USEFULLNESS AS CARDIOVASCULAR PREDICTORS J. Millana, X. Pintoa, M. Zuñigaa, A. Mangasa, A. Hernandez Mijaresa, E. Corbellaa, J.U.A.N. Pedro-Boteta a
Spanish Society of Atherosclerosis, HDL Forum, Madrid, Spain
Objectives: Cardiovascular disease management based exclusively on this lipid parameter might not be sufficient. Therapeutic guidelines, also consider other lipid factors like non HDLc, apoB, apo A-I and the total cholesterol (TC)/HDLc, some of which can be better predictors of cardiovascular risk than LDLc alone. The aim of the present study was to establish atherogenic ratios, as a marker of the atherogenicity/anti-atherogenicity balance in patients with high vascular risk receiving statin therapy, for detecting the treatable residual risk. Methods: Medical records of total of 633 ACS patients were included in the study. 478 (75.8%) had presented a myocardial infarction and 153 (24.2%) angina. A previous ACS had occurred in 43.1% of cases, and was the first episode in 56.9%. The different atherogenic indexes were analyzed. Results: 505 (79.8%) were men and 128 (20.2%) women. Patients with recurrent ACS were significantly younger, fewer were smokers, and had a higher percentage of hypertension and type 2 diabetes. Among patients with known ischemic heart disease, 187 (52.2%) were receiving lipidlowering drugs, mainly statins (50.7%) and, more rarely, fibrates (2.6%). Of those with a first ACS 21.7% were on lipid-lowering drugs: 20.1 % statins and 1.7% fibrates. Patients with recurrent ACS had similar triglyceride and HDLc levels, but significantly lower total cholesterol and LDLc concentrations compared with those presenting the first ACS. Significant differences can be found in all indexes, except for log (triglycerides)/HDLc. Patients with recurrent ACS had significantly lower non-HDLc levels, TC/HDLc and LDLc/HDLc, but higher HDLc/TC and HDLc/LDLc ratios compared with first ACS patients. Conclusion: Recurrent ACS showed a more favorable lipid profile (lower TC and LDLc and similar TG and HDLc). These findings were related to prior statin therapy. Atherogenic indexes run parallel to modifications in lipid profile and reflect the effects of lipid-lowering drugs. The unmodifiable triglyceride and HDLc concentrations account for the residual vascular risk in these patients.
Methods: Notes of consecutive patients attending a 6 week post-ACS clinic at Bradford Royal Infirmary between March 2012 and November 2013 were retrospectively reviewed for data on demographics and biochemical profiles. Results: 185 patients were included. 59% were Caucasian and 41% Asian, with a similar mean age (65.0 years [SD 13.44] vs 60.1 years [SD 13.75]). Prevalence of current smokers (37% vs 32%) and hypertension (56% vs 61%) was comparable. There was a marked discrepancy in presence of type II diabetes, 22% in Caucasians compared with 41% in Asians. 21% of Caucasians had total cholesterol > 4mM compared to 7% of Asians (OR 3.80, CI: 1.37 - 10.50, p¼0.010). 15% of Caucasians had LDL > 2mM compared with 8% of Asians (OR 2.01, CI: 0.75-5.39, p¼0.167). HDL < 1mM was present in 66% of Caucasians, versus 79% of Asians (OR 0.52, CI: 0.280.99, p¼0.043). Assessment of triglyceride levels revealed no difference (29.4% vs 32.9%, OR 0.85, CI: 0.45-1.59, p¼0.608). Compliance with statin therapy was excellent in both groups (94% vs 96%). Conclusion: This study suggests higher levels of dyslipidaemia in Caucasians compared with Asians; specifically elevated total cholesterol and lower HDL cholesterol. This trend contradicts the discrepancy in prevalence of type II diabetes between the two groups. Of reassuring note, there is excellent compliance with administration of high-dose statins. Studies utilising larger sample sizes are warranted to establish correlations further. 45 - Epidemiology of dyslipidemias EAS-0806. ETHICAL SURVEY OF HIGH CHOLESTEROL AND RISK ESTIMATION FOR FAMILIAL HYPERCHOLESTEROLEMIA IN 6320 STUDENTS OF AGES FROM 6 TO 19 YEARS A. Pereiraa, T.P. Camargoa, S.S.M. Iharaa, M.C. Eliasa, L.E.S. Almeida Pintoa, C.A. Machadoa, R.D. Santos Filhoa, S. Fernandesa, T.L.R. Martineza a
Cardiology, HCFMUSP, Sao Paulo, Brazil
Objectives: Brazilian V Guidelines (2012-Oct)Atherosclerosis Department (DA) alert to the possibility of Familial Hypercholesterolemia(FH) in children with TC> 230mg/dL . Objectives : To evaluate the TC values in students and their associations with lifestyle and socioeconomic level . Methods: Sample : 6320 students 06-19 years (55 % female) , students of public state and municipal administrations. Assay of TC i:fingertip.Samples comparable to the total universe of the studied population were assessed for lifestyle, nutritional survey(TCI ,detailed as animal proteins , carbohydrates , polyunsaturated fats , mono saturated and polyunsaturated plus fiber) with body mass index (BMII) , weight, blood pressure (BP) , socioeconomic status by income , familial aggregation and geographical housing (central , suburban– up to 20km distance and rural - from 20- to 60km) .Statistics: t test, Mann Whitney and Spearman.