Atherogenic Ratios in Patients with Recurrent Acute Coronary Syndrome and Receiving Statin Therapy: Clinical Usefullness as Cardiovascular Predictors
|Maria Ferrer Civeira1, Juan Pedro-Botet2,3, Xavier Pintó4, Manuel Zúñiga5, Alipio Mangas6, Antonio Hernandez-Mijares7, Emili Corbella4, and Jesus Millan Nuñez-Cortes1,8*|
|1Vascular Risk and Lipid Unit, Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain|
|2Vascular Risk and Lipid Unit, Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain|
|3Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain|
|4\Vascular Risk and Lipid Unit, Department of Internal Medicine, Hospital de Belvitge, Barcelona, Spain|
|5Vascular Risk and Lipid Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain|
|6Lipid Unit, Department of Internal Medicine, Hospital Universitario Puerta del Mar, Cádiz, Spain|
|7Lipid Unit, Department of Endocrinology, Hospital Universitario Dr. Peset, Valencia, Spain|
|8Department of Medicine, Faculty of Medicine at the Universidad Complutense, Madrid, Spain|
|Corresponding Author :||Jesús Millán Núñez-Corté
Vascular Risk and Lipid Unit
Department of Internal Medicine
Hospital General Universitario Gregorio Marañón
Faculty of Medicine at the Universidad Complutense
Dr. Esquerdo 46. 28007 Madrid, Spain
Tel- 91 394 1325
E-mail: [email protected]
|Received July 09, 2014; Accepted February 05, 2015; Published February 14, 2015|
|Citation: Civeira MF, Pedro-Botet J, Pintó X, Zúñiga M, Mangas A, et al. (2015) Atherogenic Ratios in Patients with Recurrent Acute Coronary Syndrome and Receiving Statin Therapy: Clinical Usefullness as Cardiovascular Predictors. J Clin Exp Cardiolog 6:358. doi:10.4172/2155-9880.1000358|
|Copyright: © 2015 Civeira MF et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Patients who have already suffered a vascular event require more and better control of cardiovascular risk factors. Different atherogenic indexes such as TC/HDLc, LDLc/HDLc, apoB/apoA-I, LDLc/apoB and non-HDLc/HDLc have been used to follow-up the patients because of their predictive capacity of the lipid profile. The aim of this study was to evaluate atherogenic ratios as a marker of the lipid residual risk in high-risk patients receiving statin therapy and to know the changes produced by previous lipid-lowering drugs treatment for a previous coronary event.
The study including patients admitted to coronary care units of six Spanish tertiary hospitals for Acute Coronary Syndrome (ACS). A total of 633 ACS patients were included; of these, 478 (75.8%) had presented a myocardial infarction and 153 (24.2%) angina. A previous ACS had occurred in 43.1% of cases, and was the first episode in 56.9% of the studied patients.
Among patients with known ischemic heart disease, 187 (52.2%) were receiving lipid-lowering drugs, mainly statins (182 patients, 50.7%). Of those with a first ACS, 59 (21.7%) were on lipid-lowering drugs: 55 (20.1%) statins and 4 (1.7%) fibrates. Patients with recurrent ACS had similar triglyceride and HDLc levels, but significantly lower total cholesterol and LDLc concentrations compared with those presenting the first ACS. Patients with recurrent ACS had significantly lower non-HDLc levels, TC/HDLc and LDLc/HDLc, but higher HDLc/TC and HDLc/LDLc ratios compared with first ACS patients.
In patients taking statins the lipid residual vascular risk was related with the persistence of cardiovascular risk factors, and related with lipid profile with dyslipemia no-LDL dependent. So, we can conclude that the correction of lipid profile by statin is not per se sufficient to control cardiovascular risk.