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Lipoprotein Disorders

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MGH Cardiology Board Review

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Abstract

Disorders of serum lipid and lipoproteins account for approximately 50 % of population-attributable risk for myocardial infarction (MI) [1, 2]. Randomized control trial (RCT) data demonstrate that treating elevated levels of low density lipoprotein (LDL) cholesterol results in substantial reductions in cardiovascular events and death [3]. Evidence-based guidelines identify serum lipids and lipoprotein disorders as important targets in primary and secondary prevention of coronary heart disease (CHD) [4, 5].

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Abbreviations

ABCA:

ATP-binding cassette transporter A

ABCG:

ATP-binding cassette transporter G

ACS:

Acute Coronary Syndrome

ATPIII:

Adult Treatment Panel III

CAD:

Coronary artery disease

CE:

Cholesterol esters

CETP:

Cholesterol ester transfer protein

CHD:

Coronary Heart Disease

CK:

Creatine kinase

CKD:

Chronic kidney disease

CM:

Chylomicron

CV:

Cardiovascular

DM:

Diabetes Mellitus

FA:

Fatty acid

FC:

Free cholesterol

FCH:

Familial combined hyperlipidemia

FDB:

Familial defective apolipoprotein B

FFA:

Free fatty acids

FH:

Familial hypercholesterolemia

FRS:

Framingham Risk Score

GFR:

Glomerular Filtration Rate

GI:

Gastrointestinal

HDL:

High density lipoprotein

HDL-C:

High density lipoprotein cholesterol

IDL:

Intermediate density lipoprotein

LCAT:

Lecithin cholesterolacyl transferase

LDL:

Low density lipoprotein

LDL-C:

Low density lipoprotein cholesterol

LDL-R:

LDL receptor

LFTs:

Liver function tests

LPL:

Lipoprotein lipase

MetS:

Metabolic syndrome

MI:

Myocardial Infarction

Non-HDL-C:

Non high density lipoprotein cholesterol

NCEP:

National Cholesterol Education Program

PCI:

Percutaneous intervention

PL:

Phospholipids

PPARα:

Peroxisome proliferator-activated receptor alpha

RCT:

Randomized control trial

RF:

Risk factors

TC:

Total cholesterol

TLC:

Therapeutic lifestyle changes

TG:

Triglycerides

T2D:

Type 2 diabetes mellitus

VLDL:

Very low density lipoprotein

References

  1. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–52.

    Article  PubMed  Google Scholar 

  2. Fruchart JC, Sacks FM, Hermans MP, Assmann G, Brown WV, Ceska R, et al. The residual risk reduction initiative: a call to action to reduce residual vascular risk in dyslipidaemic patient. Diab Vasc Dis Res. 2008;5(4):319–35.

    Article  PubMed  Google Scholar 

  3. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366(9493):1267–78.

    Article  PubMed  CAS  Google Scholar 

  4. Expert Panel on Detection, and Treatment of High Blood Cholesterol in Adults. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–421.

    Google Scholar 

  5. Grundy SM, Cleeman JI, Merz CN, Brewer Jr HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation. 2004;110(2):227–39.

    Article  PubMed  Google Scholar 

  6. Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–47.

    Article  PubMed  CAS  Google Scholar 

  7. Pekkanen J, Linn S, Heiss G, Suchindran CM, Leon A, Rifkind BM, et al. Ten-year mortality from cardiovascular disease in relation to cholesterol level among men with and without preexisting cardiovascular disease. N Eng J Med. 1990;322(24):1700–7.

    Article  CAS  Google Scholar 

  8. Gordon DJ, Probstfield JL, Garrison RJ, Neaton JD, Castelli WP, Knoke JD, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989;79(1):8–15.

    Article  PubMed  CAS  Google Scholar 

  9. Sniderman A, McQueen M, Contois J, Williams K, Furberg CD. Why is non-high-density lipoprotein cholesterol a better marker of the risk of vascular disease than low-density lipoprotein cholesterol? J Clin Lipidol. 2010;4(3):152–5.

    Article  PubMed  Google Scholar 

  10. Stubbs P, Seed M, Lane D, Collinson P, Kendall F, Noble M. Lipoprotein(a) as a risk predictor for cardiac mortality in patients with acute coronary syndromes. Eur Heart J. 1998;19(9):1355–64.

    Article  PubMed  CAS  Google Scholar 

  11. Lamarche B, Tchernof A, Moorjani S, Cantin B, Dagenais GR, Lupien PJ, et al. Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study. Circulation. 1997;95(1):69–75.

    Article  PubMed  CAS  Google Scholar 

  12. Pischon T, Girman CJ, Sacks FM, Rifai N, Stampfer MJ, Rimm EB. Non-high-density lipoprotein cholesterol and apolipoprotein B in the prediction of coronary heart disease in men. Circulation. 2005;112(22):3375–83.

    Article  PubMed  CAS  Google Scholar 

  13. Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005;294(3):326–33.

    Article  PubMed  CAS  Google Scholar 

  14. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.

    PubMed  CAS  Google Scholar 

  15. Nauck M, Warnick GR, Rifai N. Methods for measurement of LDL-cholesterol: a critical assessment of direct measurement by homogeneous assays versus calculation. Clin Chem. 2002;48(2):236–54.

    PubMed  CAS  Google Scholar 

  16. Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalmi P, Helo P, et al. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Eng J Med. 1987;317(20):1237–45.

    Article  CAS  Google Scholar 

  17. Rubins HB, Robins SJ, Collins D, Fye CL, Anderson JW, Elam MB, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Eng J Med. 1999;341(6):410–8.

    Article  CAS  Google Scholar 

  18. Keech A, Simes RJ, Barter P, Best J, Scott R, Taskinen MR, et al. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366(9500):1849–61.

    Article  PubMed  CAS  Google Scholar 

  19. Ginsberg HN, Elam MB, Lovato LC, Crouse 3rd JR, Leiter LA, Linz P, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Eng J Med. 2010;362(17):1563–74.

    Article  Google Scholar 

  20. Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA. 1975;231(4):360–81.

    Article  Google Scholar 

  21. Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Eng J Med. 2011;365(24):2255–67.

    Article  Google Scholar 

  22. Kastelein JJ, Akdim F, Stroes ES, Zwinderman AH, Bots ML, Stalenhoef AF, et al. Simvastatin with or without ezetimibe in familial hypercholesterolemia. N Eng J Med. 2008;358(14):1431–43.

    Article  CAS  Google Scholar 

  23. Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet. 2011;377(9784):2181–92.

    Article  PubMed  CAS  Google Scholar 

  24. de Jongh S, Ose L, Szamosi T, Gagne C, Lambert M, Scott R, et al. Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized, double-blind, placebo-controlled trial with simvastatin. Circulation. 2002;106(17):2231–7.

    Article  PubMed  Google Scholar 

  25. McCrindle BW, Ose L, Marais AD. Efficacy and safety of atorvastatin in children and adolescents with familial hypercholesterolemia or severe hyperlipidemia: a multicenter, randomized, placebo-controlled trial. J Pediatr. 2003;143(1):74–80.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Harvard Medical School Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Shriram Nallamshetty MD (Clinical Instructor)

  2. Harvard Medical School, Boston, USA

    Jorge Plutzky MD (Associate Professor of Medicine)

  3. Vascular Disease Prevention Program, Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Jorge Plutzky MD (Director)

Authors
  1. Shriram Nallamshetty MD
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  2. Jorge Plutzky MD
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Editor information

Editors and Affiliations

  1. Cardiology Division Yawkey Building 5B, Room 5850, Massachusetts General Hospital, Boston, Massachusetts, USA

    Hanna K. Gaggin

  2. Cardiology Division Yawkey Building, Suite 5984, Massachusetts General Hospital, Boston, Massachusetts, USA

    James L. Januzzi, Jr.

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© 2014 Springer-Verlag London

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Nallamshetty, S., Plutzky, J., Plutzky, J. (2014). Lipoprotein Disorders. In: Gaggin, H., Januzzi, Jr., J. (eds) MGH Cardiology Board Review. Springer, London. https://doi.org/10.1007/978-1-4471-4483-0_6

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  • DOI: https://doi.org/10.1007/978-1-4471-4483-0_6

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  • Print ISBN: 978-1-4471-4482-3

  • Online ISBN: 978-1-4471-4483-0

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