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

• Published in: Journal of Atherosclerosis and Thrombosis 2024/04/01, Vol.31(4), pp.478-500
• Main Authors: Yamaji, Takayuki, Harada, Takahiro, Kajikawa, Masato, Maruhashi, Tatsuya, Kishimoto, Shinji, Yusoff, Farina Mohamad, Chayama, Kazuaki, Goto, Chikara, Nakashima, Ayumu, Tomiyama, Hirofumi, Takase, Bonpei, Kohro, Takahide, Suzuki, Toru, Ishizu, Tomoko, Ueda, Shinichiro, Yamazaki, Tsutomu, Furumoto, Tomoo, Kario, Kazuomi, Inoue, Teruo, Watanabe, Kentaro, Takemoto, Yasuhiko, Hano, Takuzo, Sata, Masataka, Ishibashi, Yutaka, Node, Koichi, Maemura, Koji, Ohya, Yusuke, Furukawa, Taiji, Ito, Hiroshi, Yamashina, Akira, Koba, Shinji, Higashi, Yukihito
• Format: Article
• Language: English
• Subjects: Cardiovascular events; Cholesterol, LDL; Coronary Artery Disease - drug therapy; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Original; Risk Factors; Small dense low-density lipoprotein cholesterol; Statin; Triglycerides; Type 2 diabetes mellitus
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.64416

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.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.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.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.