Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: Evidence and guidance for management

M. John Chapman, Henry N. Ginsberg, Pierre Amarenco, Felicita Andreotti, Jan Borén, Alberico L. Catapano, Olivier S. Descamps, Edward Fisher, Petri T. Kovanen, Jan Albert Kuivenhoven, Philippe Lesnik, Luis Masana, Børge G. Nordestgaard, Kausik K. Ray, Zeljko Reiner, Marja Riitta Taskinen, Lale Tokgözoglu, Anne Tybjærg-Hansen, Gerald F. Watts

Research output: Contribution to journalArticle

Abstract

Even at low-density lipoprotein cholesterol (LDL-C) goal, patients with cardiometabolic abnormalities remain at high risk of cardiovascular events. This paper aims (i) to critically appraise evidence for elevated levels of triglyceride-rich lipoproteins (TRLs) and low levels of high-density lipoprotein cholesterol (HDL-C) as cardiovascular risk factors, and (ii) to advise on therapeutic strategies for management. Current evidence supports a causal association between elevated TRL and their remnants, low HDL-C, and cardiovascular risk. This interpretation is based on mechanistic and genetic studies for TRL and remnants, together with the epidemiological data suggestive of the association for circulating triglycerides and cardiovascular disease. For HDL, epidemiological, mechanistic, and clinical intervention data are consistent with the view that low HDL-C contributes to elevated cardiovascular risk; genetic evidence is unclear however, potentially reflecting the complexity of HDL metabolism. The Panel believes that therapeutic targeting of elevated triglycerides (

Original languageEnglish
Pages (from-to)1345-1361
Number of pages17
JournalEuropean Heart Journal
Volume32
Issue number11
DOIs
Publication statusPublished - Jun 2011

Keywords

  • Atherogenic dyslipidaemia
  • Atherosclerosis
  • Cardiovascular disease
  • Cholesterol
  • Guidelines
  • High-density lipoprotein cholesterol
  • Remnants
  • Triglyceride-rich lipoproteins
  • Triglycerides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Chapman, M. J., Ginsberg, H. N., Amarenco, P., Andreotti, F., Borén, J., Catapano, A. L., Descamps, O. S., Fisher, E., Kovanen, P. T., Kuivenhoven, J. A., Lesnik, P., Masana, L., Nordestgaard, B. G., Ray, K. K., Reiner, Z., Taskinen, M. R., Tokgözoglu, L., Tybjærg-Hansen, A., & Watts, G. F. (2011). Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: Evidence and guidance for management. European Heart Journal, 32(11), 1345-1361. https://doi.org/10.1093/eurheartj/ehr112