Levels of Cholesterol in Small LDL Particles Predict Atherosclerosis Progression and Incident CHD in the HDL-Atherosclerosis Treatment Study (HATS)

Journal Article · Wed Feb 27 00:00:00 EST 2013 · PLoS ONE

DOI:https://doi.org/10.1371/journal.pone.0056782· OSTI ID:1627586

Williams, Paul T. ^[1]; Zhao, Xue-Qiao ^[2]; Marcovina, Santica M. ^[2]; Brown, B. Greg ^[2]; Krauss, Ronald M. ^[3]

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1. Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); DOE/OSTI
2. University of Washington, Seattle, WA (United States)
3. Children’s Hospital Oakland Research Institute, Oakland, CA (United States)

Test whether angiographically-documented changes in percent stenosis and clinical endpoints (coronary-related deaths, myocardial infarctions, stroke, revascularization for worsening ischemia) in the HDL-Atherosclerosis Treatment Study (HATS) were attributable to specific LDL-subclasses. Gradient gel electrophoresis of on-study LDL-subclass cholesterol concentrations were measured in 32 placebo, 33 simvastatin-niacin, 38 antioxidant, and 39 simvastatin-niacin & antioxidant treated participants. The prespecified primary end point was the mean change per patient from the initial arteriogram to the final arteriogram in the percent stenosis caused by the most severe lesion in each of the nine proximal coronary segments. The change in the percent stenosis of the most severe proximal lesions increased in association with higher concentrations of the small LDL subfractions LDL-IIIb (24.2–24.6 nm) and LDL-IVa (23.3–24.1 nm) before (both P = 0.002) and after (P = 0.01 and P = 0.03 respectively) adjustment for treatment group and on-study HDL-cholesterol, LDL-cholesterol, and triglyceride concentrations. The associations appeared specific to lesions with ,30% baseline stenosis. When adjusted for age, sex, baseline BMI and cigarette use, the odds for primary clinical endpoints (death from coronary causes, nonfatal myocardial infarction, stroke, or revascularization for worsening ischemia) were significantly greater in subjects with higher on-study LDL-IIIb levels both before (P = 0.01) and after (P = 0.03) adjustment for treatment group and the standard lipid values. Plasma LDL-IIIb cholesterol concentrations were related to changes in coronary artery stenosis and cardiovascular events in patients with coronary artery disease and low HDL-cholesterol.

• Research Organization: Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)
• Sponsoring Organization: Clinical Nutrition Research Unit; Diabetes Endocrinology Research Center; National Institutes of Health (NIH); USDOE Office of Science (SC), Biological and Environmental Research (BER); University of Washington
• Grant/Contract Number: AC02-05CH11231
• OSTI ID: 1627586
• Journal Information: PLoS ONE, Journal Name: PLoS ONE Journal Issue: 2 Vol. 8; ISSN 1932-6203
• Publisher: Public Library of Science
• Country of Publication: United States
• Language: English

Related Subjects

60 APPLIED LIFE SCIENCES
antioxidant therapy
antioxidants
cholesterol
coronary heart disease
lipid analysis
lipoproteins
niacin
stenosis