Abstract
Many studies have confirmed the risk of coronary artery disease associated with elevated
levels of low-density lipoprotein cholesterol (LDL-C). The precise role of other lipids,
however, is still under investigation. The relation between elevated levels of triglycerides
and low levels of high-density lipoprotein cholesterol (HDL-C) is complex, and the
results of clinical trials evaluating interventions to lower triglycerides or increase
levels of HDL-C have been equivocal. Based on the data currently available, LDL-C
remains the primary target for treatment. Ongoing clinical trials will help to answer
the question of how low we should set our goals for lowering cholesterol in patients
at risk.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.Arch Intern Med. 1988; 148: 36-69
- Treatment patterns and distribution of low-density lipoprotein cholesterol levels in treatment-eligible United States adults.Am J Cardiol. 1998; 82: 61-65
- Coronary heart disease in high-risk populations.Eur Heart J. 1990; 11: 462-471
- Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease.Lancet. 1994; 344: 1383-1389
- Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.N Engl J Med. 1998; 339: 1349-1357
- Is the relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Mutiple Risk Factor Intervention Trial (MRFIT).JAMA. 1986; 256: 2823-2828
- The Lipid Research Clinics Coronary Primary Prevention Trial results, I.JAMA. 1984; 251: 351-364
- Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).JAMA. 1993; 269: 3015-3023
- Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia.N Engl J Med. 1995; 333: 1301-1307
- The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels.N Engl J Med. 1996; 335: 1001-1009
- Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels.JAMA. 1998; 279: 1615-1622
- Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease.N Engl J Med. 1999; 341: 70-76
- The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts.N Engl J Med. 1997; 336: 153-162
- Range of serum cholesterol values in the population developing coronary artery disease.Am J Cardiol. 1995; 76: 69C-77C
- Incidence of coronary heart disease and lipoprotein cholesterol levels.JAMA. 1986; 256: 2835-2838
- Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study.Circulation. 1992; 85: 37-45
- Relation between baseline lipid and lipoprotein values and the incidence of coronary heart disease in the Helsinki Heart Study.Am J Cardiol. 1989; 63: 42H-47H
- Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol.N Engl J Med. 1999; 341: 410-418
- Relation of gemfibrozil treatment and lipid levels with major coronary events. VA-HIT.JAMA. 2001; 285: 1585-1591
- Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with CAD.Circulation. 2000; 102: 21-27
- Triglycerides influence mortality primarily in the setting of elevated LDL.J Am Coll Cardiol. 2000; 35 ([abstract]): 309
- Elevated serum triglyceride levels and long-term mortality in patients with coronary heart disease.Circulation. 1999; 100: 475-482
- Comparison of statins in hypertriglyceridemia.Am J Cardiol. 1998; 81: 66B-69B
- Changes in composition and distribution of LDL subspecies in hypertriglyceridemia and hypercholesterolemic patients during gemfibrozil therapy.Atherosclerosis. 1994; 110: 1-11
- Relation between baseline and on-treatment lipid parameters and first acute major coronary events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS).Circulation. 2000; 101: 477-487
- Hypertriglyceridemia, atherogenic dyslipidemia, and the metabolic syndrome.Am J Cardiol. 1998; 81: 18B-25B
- New perspectives on the management of low levels of high-density lipoprotein cholesterol.Arch Intern Med. 1999; 159: 1049-1057
- Influence of low HDL on progression of coronary artery disease and response to fluvastatin therapy.Circulation. 1999; 99: 736-743
- Correlates of high HDL cholesterol among women with coronary heart disease.Am Heart J. 2000; 139: 288-296
- Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women.JAMA. 1998; 280: 605-613
- Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).JAMA. 2001; 285: 2486-2496
LaRosa JC. Effect of lowering LDL cholesterol beyond currently recommended minimum targets: the Treating to New Targets (TNT) study. In: Program and Abstracts of the XIII International Symposium on Drugs Affecting Lipid Metabolism. Florence, Italy: May 30–June 3, 1998.
- MRC/BHF Heart Protection Study of cholesterol-lowering therapy and of antioxidant vitamin supplementation in a wide range of patients at increased risk of coronary heart disease death.Eur Heart J. 1999; 20: 725-741
- The Lipid Treatment Assessment Project (L-TAP).Arch Intern Med. 2000; 160: 459-467
Article info
Identification
Copyright
© 2001 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
