Targets of statin therapy:

LDL cholesterol, non-HDL cholesterol, and apoliproprotein B in Type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS)

Valentine Charlton-Menys, D. John Betteridge, Helen Colhoun, John Fuller, Michael France, Graham A. Hitman, Shona J. Livingstone, H. Andrew W. Neil, Connie B. Newman, Michael Szarek, David A. DeMicco, Paul N. Durrington

    Research output: Contribution to journalArticle

    65 Citations (Scopus)

    Abstract

    BACKGROUND: LDL can vary considerably in its cholesterol content; thus, lowering LDL cholesterol (LDLC) as a goal of statin treatment implies the existence of considerable variation in the extent to which statin treatment removes circulating LDL particles. This consideration is particularly applicable in diabetes mellitus, in which LDL is frequently depleted of cholesterol.

    METHODS: Type 2 diabetes patients randomly allocated to 10 mg/day atorvastatin (n = 1154) or to placebo (n = 1196) for 1 year were studied to compare spontaneous and statin-induced apolipoprotein B (apo B) concentrations (a measure of LDL particle concentration) at LDLC and non-HDL cholesterol (non-HDLC) concentrations proposed as statin targets in type 2 diabetes.

    RESULTS: Patients treated with atorvastatin produced lower serum apo B concentrations at any given LDLC concentration than patients on placebo. All LDLC concentration of 1.8 mmol/L (70 mg/dL) during atorvastatin treatment was equivalent to a non-HDLC concentration of 2.59 mmol/L (100 mg/dL) or an apo B concentration of 0.8 g/L. At the more conservative LDLC targets of 2.59 mmol/L (100 mg/dL) and 3.37 mmol/L (130 mg/dL) for non-HDLC, however, the apo B concentration exceeded the 0.9-g/L value anticipated in the recent Consensus Statement from the American Diabetes Association and the American College of Cardiology.

    CONCLUSIONS: The apo B concentration provides a more consistent goal for statin treatment than the LDLC or non-HDLC concentration. (C) 2008 American Association for Clinical Chemistry

    Original languageEnglish
    Pages (from-to)473-480
    Number of pages8
    JournalClinical Chemistry
    Volume55
    Issue number3
    DOIs
    Publication statusPublished - Mar 2009

    Keywords

    • Low density lipoprotein
    • Coronary heart disease
    • 14 randomized trials
    • Cardiovascular disease
    • Apolipoprotein-B
    • APO-B
    • Combined hyperlipidemia
    • Primary prevention
    • Clinical practice
    • Ester transfer

    Cite this

    Charlton-Menys, Valentine ; Betteridge, D. John ; Colhoun, Helen ; Fuller, John ; France, Michael ; Hitman, Graham A. ; Livingstone, Shona J. ; Neil, H. Andrew W. ; Newman, Connie B. ; Szarek, Michael ; DeMicco, David A. ; Durrington, Paul N. / Targets of statin therapy: LDL cholesterol, non-HDL cholesterol, and apoliproprotein B in Type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS). In: Clinical Chemistry. 2009 ; Vol. 55, No. 3. pp. 473-480.
    @article{7e09c0bb54fe466997aa31f331cba6e8,
    title = "Targets of statin therapy:: LDL cholesterol, non-HDL cholesterol, and apoliproprotein B in Type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS)",
    abstract = "BACKGROUND: LDL can vary considerably in its cholesterol content; thus, lowering LDL cholesterol (LDLC) as a goal of statin treatment implies the existence of considerable variation in the extent to which statin treatment removes circulating LDL particles. This consideration is particularly applicable in diabetes mellitus, in which LDL is frequently depleted of cholesterol.METHODS: Type 2 diabetes patients randomly allocated to 10 mg/day atorvastatin (n = 1154) or to placebo (n = 1196) for 1 year were studied to compare spontaneous and statin-induced apolipoprotein B (apo B) concentrations (a measure of LDL particle concentration) at LDLC and non-HDL cholesterol (non-HDLC) concentrations proposed as statin targets in type 2 diabetes.RESULTS: Patients treated with atorvastatin produced lower serum apo B concentrations at any given LDLC concentration than patients on placebo. All LDLC concentration of 1.8 mmol/L (70 mg/dL) during atorvastatin treatment was equivalent to a non-HDLC concentration of 2.59 mmol/L (100 mg/dL) or an apo B concentration of 0.8 g/L. At the more conservative LDLC targets of 2.59 mmol/L (100 mg/dL) and 3.37 mmol/L (130 mg/dL) for non-HDLC, however, the apo B concentration exceeded the 0.9-g/L value anticipated in the recent Consensus Statement from the American Diabetes Association and the American College of Cardiology.CONCLUSIONS: The apo B concentration provides a more consistent goal for statin treatment than the LDLC or non-HDLC concentration. (C) 2008 American Association for Clinical Chemistry",
    keywords = "Low density lipoprotein, Coronary heart disease, 14 randomized trials, Cardiovascular disease, Apolipoprotein-B, APO-B, Combined hyperlipidemia, Primary prevention, Clinical practice, Ester transfer",
    author = "Valentine Charlton-Menys and Betteridge, {D. John} and Helen Colhoun and John Fuller and Michael France and Hitman, {Graham A.} and Livingstone, {Shona J.} and Neil, {H. Andrew W.} and Newman, {Connie B.} and Michael Szarek and DeMicco, {David A.} and Durrington, {Paul N.}",
    year = "2009",
    month = "3",
    doi = "10.1373/clinchem.2008.111401",
    language = "English",
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    Charlton-Menys, V, Betteridge, DJ, Colhoun, H, Fuller, J, France, M, Hitman, GA, Livingstone, SJ, Neil, HAW, Newman, CB, Szarek, M, DeMicco, DA & Durrington, PN 2009, 'Targets of statin therapy: LDL cholesterol, non-HDL cholesterol, and apoliproprotein B in Type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS)', Clinical Chemistry, vol. 55, no. 3, pp. 473-480. https://doi.org/10.1373/clinchem.2008.111401

    Targets of statin therapy: LDL cholesterol, non-HDL cholesterol, and apoliproprotein B in Type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS). / Charlton-Menys, Valentine; Betteridge, D. John; Colhoun, Helen; Fuller, John; France, Michael; Hitman, Graham A.; Livingstone, Shona J.; Neil, H. Andrew W.; Newman, Connie B.; Szarek, Michael; DeMicco, David A.; Durrington, Paul N.

    In: Clinical Chemistry, Vol. 55, No. 3, 03.2009, p. 473-480.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Targets of statin therapy:

    T2 - LDL cholesterol, non-HDL cholesterol, and apoliproprotein B in Type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS)

    AU - Charlton-Menys, Valentine

    AU - Betteridge, D. John

    AU - Colhoun, Helen

    AU - Fuller, John

    AU - France, Michael

    AU - Hitman, Graham A.

    AU - Livingstone, Shona J.

    AU - Neil, H. Andrew W.

    AU - Newman, Connie B.

    AU - Szarek, Michael

    AU - DeMicco, David A.

    AU - Durrington, Paul N.

    PY - 2009/3

    Y1 - 2009/3

    N2 - BACKGROUND: LDL can vary considerably in its cholesterol content; thus, lowering LDL cholesterol (LDLC) as a goal of statin treatment implies the existence of considerable variation in the extent to which statin treatment removes circulating LDL particles. This consideration is particularly applicable in diabetes mellitus, in which LDL is frequently depleted of cholesterol.METHODS: Type 2 diabetes patients randomly allocated to 10 mg/day atorvastatin (n = 1154) or to placebo (n = 1196) for 1 year were studied to compare spontaneous and statin-induced apolipoprotein B (apo B) concentrations (a measure of LDL particle concentration) at LDLC and non-HDL cholesterol (non-HDLC) concentrations proposed as statin targets in type 2 diabetes.RESULTS: Patients treated with atorvastatin produced lower serum apo B concentrations at any given LDLC concentration than patients on placebo. All LDLC concentration of 1.8 mmol/L (70 mg/dL) during atorvastatin treatment was equivalent to a non-HDLC concentration of 2.59 mmol/L (100 mg/dL) or an apo B concentration of 0.8 g/L. At the more conservative LDLC targets of 2.59 mmol/L (100 mg/dL) and 3.37 mmol/L (130 mg/dL) for non-HDLC, however, the apo B concentration exceeded the 0.9-g/L value anticipated in the recent Consensus Statement from the American Diabetes Association and the American College of Cardiology.CONCLUSIONS: The apo B concentration provides a more consistent goal for statin treatment than the LDLC or non-HDLC concentration. (C) 2008 American Association for Clinical Chemistry

    AB - BACKGROUND: LDL can vary considerably in its cholesterol content; thus, lowering LDL cholesterol (LDLC) as a goal of statin treatment implies the existence of considerable variation in the extent to which statin treatment removes circulating LDL particles. This consideration is particularly applicable in diabetes mellitus, in which LDL is frequently depleted of cholesterol.METHODS: Type 2 diabetes patients randomly allocated to 10 mg/day atorvastatin (n = 1154) or to placebo (n = 1196) for 1 year were studied to compare spontaneous and statin-induced apolipoprotein B (apo B) concentrations (a measure of LDL particle concentration) at LDLC and non-HDL cholesterol (non-HDLC) concentrations proposed as statin targets in type 2 diabetes.RESULTS: Patients treated with atorvastatin produced lower serum apo B concentrations at any given LDLC concentration than patients on placebo. All LDLC concentration of 1.8 mmol/L (70 mg/dL) during atorvastatin treatment was equivalent to a non-HDLC concentration of 2.59 mmol/L (100 mg/dL) or an apo B concentration of 0.8 g/L. At the more conservative LDLC targets of 2.59 mmol/L (100 mg/dL) and 3.37 mmol/L (130 mg/dL) for non-HDLC, however, the apo B concentration exceeded the 0.9-g/L value anticipated in the recent Consensus Statement from the American Diabetes Association and the American College of Cardiology.CONCLUSIONS: The apo B concentration provides a more consistent goal for statin treatment than the LDLC or non-HDLC concentration. (C) 2008 American Association for Clinical Chemistry

    KW - Low density lipoprotein

    KW - Coronary heart disease

    KW - 14 randomized trials

    KW - Cardiovascular disease

    KW - Apolipoprotein-B

    KW - APO-B

    KW - Combined hyperlipidemia

    KW - Primary prevention

    KW - Clinical practice

    KW - Ester transfer

    U2 - 10.1373/clinchem.2008.111401

    DO - 10.1373/clinchem.2008.111401

    M3 - Article

    VL - 55

    SP - 473

    EP - 480

    JO - Clinical Chemistry

    JF - Clinical Chemistry

    SN - 0009-9147

    IS - 3

    ER -