Lp(a) (lipoprotein(a)) levels predict progression of carotid atherosclerosis in subjects with atherosclerotic cardiovascular disease on intensive lipid therapy an analysis of the AIM-HIGH (atherothrombosis intervention in metabolic syndrome with low HDL/high triglycerides: Impact on global health outcomes) carotid magnetic resonance imaging substudy-brief report

Daniel S. Hippe, Binh An P. Phan, Jie Sun, Daniel A. Isquith, Kevin D. O'Brien, John R. Crouse, Todd Anderson, John III Huston, Santica M. Marcovina, Thomas S. Hatsukami, Chun Yuan, Xue Qiao Zhao

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective-To assess whether Lp(a) (lipoprotein(a)) levels and other lipid levels were predictive of progression of atherosclerosis burden as assessed by carotid magnetic resonance imaging in subjects who have been treated with LDL-C (low-density lipoprotein cholesterol)-lowering therapy and participated in the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes). Approach and Results-AIM-HIGH was a randomized, double-blind study of subjects with established vascular disease, elevated triglycerides, and low HDL-C (high-density lipoprotein cholesterol). One hundred fifty-two AIM-HIGH subjects underwent both baseline and 2-year follow-up carotid artery magnetic resonance imaging. Plaque burden was measured by the percent wall volume (%WV) of the carotid artery. Associations between annualized change in %WV with baseline and on-study (1 year) lipid variables were evaluated using multivariate linear regression and the Bonferroni correction to account for multiple comparisons. Average %WV at baseline was 41.6±6.8% and annualized change in %WV over 2 years ranged from -3.2% to 3.7% per year (mean: 0.2±1.1% per year; P=0.032). Increases in %WV were significantly associated with higher baseline Lp(a) (β=0.34 per 1-SD increase of Lp(a); 95% confidence interval, 0.15-0.52; P<0.001) after adjusting for clinical risk factors and other lipid levels. On-study Lp(a) had a similar positive association with %WV progression (β=0.33; 95% confidence interval, 0.15-0.52; P<0.001). Conclusions-Despite intensive lipid therapy, aimed at aggressively lowering LDL-C to <70 mg/dL, carotid atherosclerosis continued to progress as assessed by carotid magnetic resonance imaging and that elevated Lp(a) levels were independent predictors of increases in atherosclerosis burden.

Original languageEnglish (US)
Pages (from-to)673-678
Number of pages6
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume38
Issue number3
DOIs
StatePublished - Jan 1 2018

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Lipoprotein(a)
Carotid Artery Diseases
Triglycerides
Cardiovascular Diseases
Magnetic Resonance Imaging
Lipids
LDL Cholesterol
Carotid Arteries
Atherosclerosis
Confidence Intervals
Therapeutics
Vascular Diseases
Double-Blind Method
HDL Cholesterol
Linear Models
Global Health

Keywords

  • Atherosclerosis
  • Lipids
  • Lipoprotein
  • Lipoprotein(a)
  • Lp(a)
  • Risk factors
  • Triglycerides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Lp(a) (lipoprotein(a)) levels predict progression of carotid atherosclerosis in subjects with atherosclerotic cardiovascular disease on intensive lipid therapy an analysis of the AIM-HIGH (atherothrombosis intervention in metabolic syndrome with low HDL/high triglycerides : Impact on global health outcomes) carotid magnetic resonance imaging substudy-brief report. / Hippe, Daniel S.; Phan, Binh An P.; Sun, Jie; Isquith, Daniel A.; O'Brien, Kevin D.; Crouse, John R.; Anderson, Todd; Huston, John III; Marcovina, Santica M.; Hatsukami, Thomas S.; Yuan, Chun; Zhao, Xue Qiao.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 38, No. 3, 01.01.2018, p. 673-678.

Research output: Contribution to journalArticle

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title = "Lp(a) (lipoprotein(a)) levels predict progression of carotid atherosclerosis in subjects with atherosclerotic cardiovascular disease on intensive lipid therapy an analysis of the AIM-HIGH (atherothrombosis intervention in metabolic syndrome with low HDL/high triglycerides: Impact on global health outcomes) carotid magnetic resonance imaging substudy-brief report",
abstract = "Objective-To assess whether Lp(a) (lipoprotein(a)) levels and other lipid levels were predictive of progression of atherosclerosis burden as assessed by carotid magnetic resonance imaging in subjects who have been treated with LDL-C (low-density lipoprotein cholesterol)-lowering therapy and participated in the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes). Approach and Results-AIM-HIGH was a randomized, double-blind study of subjects with established vascular disease, elevated triglycerides, and low HDL-C (high-density lipoprotein cholesterol). One hundred fifty-two AIM-HIGH subjects underwent both baseline and 2-year follow-up carotid artery magnetic resonance imaging. Plaque burden was measured by the percent wall volume ({\%}WV) of the carotid artery. Associations between annualized change in {\%}WV with baseline and on-study (1 year) lipid variables were evaluated using multivariate linear regression and the Bonferroni correction to account for multiple comparisons. Average {\%}WV at baseline was 41.6±6.8{\%} and annualized change in {\%}WV over 2 years ranged from -3.2{\%} to 3.7{\%} per year (mean: 0.2±1.1{\%} per year; P=0.032). Increases in {\%}WV were significantly associated with higher baseline Lp(a) (β=0.34 per 1-SD increase of Lp(a); 95{\%} confidence interval, 0.15-0.52; P<0.001) after adjusting for clinical risk factors and other lipid levels. On-study Lp(a) had a similar positive association with {\%}WV progression (β=0.33; 95{\%} confidence interval, 0.15-0.52; P<0.001). Conclusions-Despite intensive lipid therapy, aimed at aggressively lowering LDL-C to <70 mg/dL, carotid atherosclerosis continued to progress as assessed by carotid magnetic resonance imaging and that elevated Lp(a) levels were independent predictors of increases in atherosclerosis burden.",
keywords = "Atherosclerosis, Lipids, Lipoprotein, Lipoprotein(a), Lp(a), Risk factors, Triglycerides",
author = "Hippe, {Daniel S.} and Phan, {Binh An P.} and Jie Sun and Isquith, {Daniel A.} and O'Brien, {Kevin D.} and Crouse, {John R.} and Todd Anderson and Huston, {John III} and Marcovina, {Santica M.} and Hatsukami, {Thomas S.} and Chun Yuan and Zhao, {Xue Qiao}",
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language = "English (US)",
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pages = "673--678",
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T1 - Lp(a) (lipoprotein(a)) levels predict progression of carotid atherosclerosis in subjects with atherosclerotic cardiovascular disease on intensive lipid therapy an analysis of the AIM-HIGH (atherothrombosis intervention in metabolic syndrome with low HDL/high triglycerides

T2 - Impact on global health outcomes) carotid magnetic resonance imaging substudy-brief report

AU - Hippe, Daniel S.

AU - Phan, Binh An P.

AU - Sun, Jie

AU - Isquith, Daniel A.

AU - O'Brien, Kevin D.

AU - Crouse, John R.

AU - Anderson, Todd

AU - Huston, John III

AU - Marcovina, Santica M.

AU - Hatsukami, Thomas S.

AU - Yuan, Chun

AU - Zhao, Xue Qiao

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective-To assess whether Lp(a) (lipoprotein(a)) levels and other lipid levels were predictive of progression of atherosclerosis burden as assessed by carotid magnetic resonance imaging in subjects who have been treated with LDL-C (low-density lipoprotein cholesterol)-lowering therapy and participated in the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes). Approach and Results-AIM-HIGH was a randomized, double-blind study of subjects with established vascular disease, elevated triglycerides, and low HDL-C (high-density lipoprotein cholesterol). One hundred fifty-two AIM-HIGH subjects underwent both baseline and 2-year follow-up carotid artery magnetic resonance imaging. Plaque burden was measured by the percent wall volume (%WV) of the carotid artery. Associations between annualized change in %WV with baseline and on-study (1 year) lipid variables were evaluated using multivariate linear regression and the Bonferroni correction to account for multiple comparisons. Average %WV at baseline was 41.6±6.8% and annualized change in %WV over 2 years ranged from -3.2% to 3.7% per year (mean: 0.2±1.1% per year; P=0.032). Increases in %WV were significantly associated with higher baseline Lp(a) (β=0.34 per 1-SD increase of Lp(a); 95% confidence interval, 0.15-0.52; P<0.001) after adjusting for clinical risk factors and other lipid levels. On-study Lp(a) had a similar positive association with %WV progression (β=0.33; 95% confidence interval, 0.15-0.52; P<0.001). Conclusions-Despite intensive lipid therapy, aimed at aggressively lowering LDL-C to <70 mg/dL, carotid atherosclerosis continued to progress as assessed by carotid magnetic resonance imaging and that elevated Lp(a) levels were independent predictors of increases in atherosclerosis burden.

AB - Objective-To assess whether Lp(a) (lipoprotein(a)) levels and other lipid levels were predictive of progression of atherosclerosis burden as assessed by carotid magnetic resonance imaging in subjects who have been treated with LDL-C (low-density lipoprotein cholesterol)-lowering therapy and participated in the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes). Approach and Results-AIM-HIGH was a randomized, double-blind study of subjects with established vascular disease, elevated triglycerides, and low HDL-C (high-density lipoprotein cholesterol). One hundred fifty-two AIM-HIGH subjects underwent both baseline and 2-year follow-up carotid artery magnetic resonance imaging. Plaque burden was measured by the percent wall volume (%WV) of the carotid artery. Associations between annualized change in %WV with baseline and on-study (1 year) lipid variables were evaluated using multivariate linear regression and the Bonferroni correction to account for multiple comparisons. Average %WV at baseline was 41.6±6.8% and annualized change in %WV over 2 years ranged from -3.2% to 3.7% per year (mean: 0.2±1.1% per year; P=0.032). Increases in %WV were significantly associated with higher baseline Lp(a) (β=0.34 per 1-SD increase of Lp(a); 95% confidence interval, 0.15-0.52; P<0.001) after adjusting for clinical risk factors and other lipid levels. On-study Lp(a) had a similar positive association with %WV progression (β=0.33; 95% confidence interval, 0.15-0.52; P<0.001). Conclusions-Despite intensive lipid therapy, aimed at aggressively lowering LDL-C to <70 mg/dL, carotid atherosclerosis continued to progress as assessed by carotid magnetic resonance imaging and that elevated Lp(a) levels were independent predictors of increases in atherosclerosis burden.

KW - Atherosclerosis

KW - Lipids

KW - Lipoprotein

KW - Lipoprotein(a)

KW - Lp(a)

KW - Risk factors

KW - Triglycerides

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