Role of Small Dense Low-density Lipoprotein Cholesterol in Cardiovascular Events in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus Receiving Statin Treatment

  • Yamaji Takayuki
    Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
  • Harada Takahiro
    Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
  • Kajikawa Masato
    Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
  • Maruhashi Tatsuya
    Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Kishimoto Shinji
    Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Yusoff Farina Mohamad
    Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Chayama Kazuaki
    Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
  • Goto Chikara
    Department of Physical Therapy, Hiroshima International University, Hiroshima, Japan
  • Nakashima Ayumu
    Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
  • Tomiyama Hirofumi
    Department of Cardiology, Tokyo Medical University, Tokyo, Japan
  • Takase Bonpei
    Division of Biomedical Engineering, National Defense Medical College Research Institute, Tokorozawa, Japan
  • Kohro Takahide
    Department of Clinical Informatics, Jichi Medical University School of Medicine, Tochigi, Japan
  • Suzuki Toru
    Cardiovascular Medicine, University of Leicester, Leicester, UK
  • Ishizu Tomoko
    Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
  • Ueda Shinichiro
    Department of Clinical Pharmacology and Therapeutics, University of the Ryukyu School of Medicine, Okinawa, Japan
  • Yamazaki Tsutomu
    Department of Clinical Epidemiology and Systems, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
  • Furumoto Tomoo
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
  • Kario Kazuomi
    Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
  • Inoue Teruo
    Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
  • Watanabe Kentaro
    Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetelogy (DNHMED), Yamagata University School of Medicine, Yamagata, Japan
  • Takemoto Yasuhiko
    Department of Internal Medicine and Cardiology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
  • Hano Takuzo
    Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University, Wakayama, Japan
  • Sata Masataka
    Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
  • Ishibashi Yutaka
    Department of General Medicine, Shimane University Faculty of Medicine, Izumo, Japan
  • Node Koichi
    Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan
  • Maemura Koji
    Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
  • Ohya Yusuke
    The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan
  • Furukawa Taiji
    Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
  • Ito Hiroshi
    Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
  • Yamashina Akira
    Department of Cardiology, Tokyo Medical University, Tokyo, Japan
  • Koba Shinji
    Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
  • Higashi Yukihito
    Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

Description

<p> Aim: There is little information on the relationships of serum small dense low-density lipoprotein cholesterol (sdLDL-C) levels and serum triglyceride (TG) levels with cardiovascular events in patients with coronary artery disease (CAD) and type 2 diabetes mellitus (DM) who are receiving statins. The aim of this study was to evaluate the relationships of serum TG levels and sdLDL-C levels as residual risks for cardiovascular events in patients with CAD and type 2 DM who were being treated with statins.</p><p>Methods: The subjects were divided into four groups based on TG levels and sdLDL-C levels: sdLDL-C of <40.0 mg/dL and TG of <150 mg/dL, sdLDL-C of ≥ 40.0 mg/dL and TG of <150 mg/dL, sdLDL-C of <40.0 mg/dL and TG of ≥ 150 mg/dL, and sdLDL-C of ≥ 40.0 mg/dL and TG of ≥ 150 mg/dL. During a median follow-up period of 1419 days, cardiovascular events occurred in 34 patients.</p><p>Results: The incidences of cardiovascular events were significantly higher in patients with sdLDL-C of ≥ 40.0 mg/dL and TG of <150 mg/dL and in patients with sdLDL-C of ≥ 40.0 mg/dL and TG of ≥ 150 mg/dL, but not in patients with sdLDL-C of <40.0 mg/dL and TG of ≥ 150 mg/dL, than in patients with sdLDL-C of <40.0 mg/dL and TG of <150 mg/dL.</p><p>Conclusions: Under the condition of treatment with statins, patients with CAD and type 2 DM who had sdLDL-C levels of ≥ 40.0 mg/dL had a high risk for cardiovascular events even though serum TG levels were controlled at <150 mg/dL.</p>

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