BIRMINGHAM, Ala., Jan. 20, 2015 /PRNewswire/ -- Data analyzed from two complementary prospective cohort studies demonstrated the benefit of measuring subclasses of high-density lipoprotein cholesterol (HDL-C). In the most recent issue of the European Heart Journal, investigators published new data directly measuring HDL-C – the "good" cholesterol in the body – and the subclasses of this specific lipoprotein, in patients with established coronary heart disease (CHD). Recent clinical trials on HDL-C have failed to show a benefit of certain drugs that raise total HDL-C on cardiovascular risk. Other studies have suggested that the HDL3 subfraction is more strongly associated with lower CHD risk. The present study used the Vertical Auto Profile (VAP®) Lipid Panel—a commercially available cholesterol test that uses density gradient ultracentrification and directly measures lipoproteins—to directly measure the subclasses of HDL, and more specifically the role that HDL3 cholesterol (HDL3-C) plays in predicting hard clinical events, namely myocardial infarction (MI) and death. The conclusion of this study analysis was that in secondary prevention, increased risk for long-term hard clinical events is associated with low HDL3-C but not HDL2-C or total HDL-C, highlighting the value of sub classifying HDL-C. There was a >50% higher risk for people with the lowest HDL3-C levels. Researchers from the Lipoprotein Investigators Collaborative (LIC) examined data from two complementary, prospective cohorts: the Translational Research Investigating Underlying disparities in acute Myocardial infarction Patient's Health status (TRIUMPH) study and the Intermountain Heart Collaborative Study (IHCS).
"For decades, the de facto standard for HDL assessment has been its total cholesterol content. Low HDL cholesterol levels have been linked to CHD, the leading cause of death in the United States," lead investigator Dr. Seth S. Martin of Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore, Maryland, said. "However, what has become apparent is that total HDL cholesterol concentration is a remarkably simple measure for a staggeringly complex lipoprotein. Our collaborative study highlights the information that can be gained by moving to a higher-resolution measure."
To better understand the associations of HDL subclasses, researchers analyzed data from the TRIUMPH and IHCS studies of secondary prevention patients in whom HDL-C was sub classified by a common method of ultracentrifugation. The TRIUMPH study enrolled 2,465 acute MI patients, and the IHCS study enrolled 2,414 patients who underwent coronary angiography. TRIUMPH participants were included on the basis of acute MI and IHCS participants on the basis of coronary angiography for MI, unstable angina or stable angina. The participants were followed out to 5 years and the researchers adjusted analyses for a robust set of potential confounders.
According to researchers, this is the largest and most completely adjusted observational study seeking to define the independent associations of HDL-C and its subclasses with clinical outcomes in patients with established CHD. Additionally, in CHD patients, it is also the first to examine mortality as an endpoint in relation to HDL2-C versus HDL3-C.
"While these results substantially advance our understanding of the underlying biologic and epidemiologic relationships in secondary prevention, they fall short of clarifying the uncertainty and complexity surrounding HDL-based therapeutic strategies," said senior investigator on the study, Dr. Steven R. Jones of Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.
Findings were previously published in the June 30 online edition of the European Heart Journal.
Atherotech Diagnostics Lab, a leading clinical reference laboratory specializing in cardiometabolic testing and disease management solutions, is the maker of the VAP®+ Lipid Panel. For more information on Atherotech or the VAP®+ Lipid Panel, visit www.Atherotech.com.
About The Lipoprotein Investigators Collaborative
The Lipoprotein Investigators Collaborative study group is a collaborative effort across four studies including the primary prevention cohorts, the Jackson Heart Study (JHS) and the Framingham Offspring Cohort Study (FOCS), and the secondary prevention cohorts consisting of the Translational Research Investigating Underlying disparities in acute Myocardial infarction Patient's Health status (TRIUMPH) registry and Intermountain Heart Collaborative Study (IHCS) of patients undergoing clinically-indicated coronary angiography. The data for each study are housed at the statistical center for the respective study. The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease serves as the coordinating center for the LIC study group.
About Atherotech and the VAP®+ Lipid Panel
Atherotech Diagnostics Lab is a leading clinical reference laboratory specializing in cardiometabolic testing and disease management solutions. Atherotech's proprietary and comprehensive VAP®+ Lipid Panel enables clinicians to accurately stratify a patient's cardiovascular risk and deliver personalized treatment strategies to improve health outcomes. The Vertical Auto Profile (VAP+) technology reveals residual cardiometabolic risk as recommended in the NCEP ATP III, ADA/ACC Joint Consensus and AACE guidelines. The VAP+ utilizes direct measurement to identify cholesterol, triglyceride and genetic lipid disorders. The company's dedication to affordable, comprehensive disease management solutions includes Our Healthy Heart™, a patient consultation program and expert lipid management education service to health care providers. For more information, please visit www.Atherotech.com or call 1-866-VAP-TEST.
For information on the VAP+ Lipid Panel and Atherotech Diagnostics Lab, visit www.Atherotech.com or call 877-901-8510. Healthcare professionals interested in real cases from the trenches of lipidology may visit www.CobblesCorner.com, Atherotech's official blog. Atherotech is on Twitter at www.twitter.com/Atherotech, on Facebook at www.facebook.com/Atherotech, and broadcasting at www.YouTube.com/user/VAPatherotech.
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