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  • Title: Prognostic value of remnant-like lipoprotein particle levels in patients with coronary artery disease and type II diabetes mellitus.
    Author: Fukushima H, Sugiyama S, Honda O, Koide S, Nakamura S, Sakamoto T, Yoshimura M, Ogawa H, Fujioka D, Kugiyama K.
    Journal: J Am Coll Cardiol; 2004 Jun 16; 43(12):2219-24. PubMed ID: 15193683.
    Abstract:
    OBJECTIVES: This study prospectively examined whether the levels of high remnant-like lipoprotein particles (RLP) cholesterol have a significant risk and influence prognosis in patients with coronary artery disease (CAD) and type II diabetes mellitus (DM). BACKGROUND: Several studies have shown that triglyceride-rich lipoproteins contribute to atherosclerotic complications in type II DM. However, it remains to be established which triglyceride-rich lipoproteins contribute to this risk. METHODS: Levels of RLP cholesterol in fasting serum were measured by an immunoseparation method in 240 type II DM patients with (n = 120) or without (n = 120) CAD. The patients with CAD were followed up for a period of < or =24 months until the occurrence of one of the following clinical coronary events: re-admission or coronary revascularization due to recurrent or refractory angina pectoris, nonfatal myocardial infarction, or cardiac death. RESULTS: Patients with CAD had higher RLP levels than patients without CAD. Multivariate logistic regression analysis showed that high RLP cholesterol levels (>4.7 mg cholesterol/dl, representing the 75th percentile of the distribution of RLP cholesterol levels in control subjects) were a significant risk factor for the presence of CAD, independent of traditional risk factors. Kaplan-Meier analysis demonstrated that higher RLP cholesterol levels in patients with CAD resulted in a significantly higher probability for the development of coronary events. Multivariate Cox hazards analysis showed that high RLP cholesterol levels in patients with CAD were a significant predictor of future coronary events, independent of other risk factors. CONCLUSIONS: Increased levels of RLP cholesterol are a significant and independent risk factor of CAD and predict future coronary events in patients with CAD and type II DM.
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