Lipoprotein(a) Cholesterol, Randomized Omega-3 Fatty Acid Supplementation, and Cardiovascular Events: Extended Follow-up in the VITamin D and OmegA 3 TriaL

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2025-05-01 DOI:10.1016/j.jacl.2025.04.092

Heike Luttmann-Gibson PhD, Nancy Cook ScD, Chunying Li MPH, Olga Demler PhD, Krishnaji Kulkarni PhD, Ajala Oluremi MBBS, Julie Buring ScD, Jacqueline Danik MD, JoAnn Manson MD, Samia Mora MD, Zareen Farukhi MD

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引用次数: 0

Abstract

Background/Synopsis

It is unclear if lipoprotein(a) cholesterol (LpaC), the cholesterol carried by lipoprotein(a) [Lp(a)], is associated with cardiovascular disease (CVD) similar to Lp(a) mass or molar concentration, and if omega-3 fatty acids (n-3 FA) modify risk.

Objective/Purpose

We hypothesized that individuals with LpaC > 75th percentile population distribution would be at higher incident CVD events compared to those at < 25th percentile levels, and that n-3FA supplementation may modify this risk.

Methods

13,175 participants of the VITAL trial (NCT01169259) had baseline LpaC measured by density-gradient ultracentrifugation (Atherotec Diagnostics) and were examined for incident CVD (n = 701; mean follow-up 9.8 years) by Cox models adjusted for risk factors. In a subset of participants (N =1639) with repeated baseline and 1 year LpaC, we also analyzed randomized n-3 FA effects (1 g/d EPA+DHA) vs. placebo.

Results

In both unadjusted and adjusted models, there was no significant association for higher baseline LpaC levels with increased risk of CVD (Table). There was no effect modification (P interaction > 0.05) by n-3 FA, race, sex or LDL-C. N-3 FA increased median LpaC from 7 mg/dL (IQR, 5-10) at baseline to 8 mg/dL [IQR, 5-10] at 1 year (mean increase of 4.05% vs placebo, p = 0.006 using natural logarithmic transformation for mean LpaC percent change).

Conclusions

In the VITAL trial, baseline LpaC levels were not related to higher risk of incident CVD events. Further, n-3 FA supplementation (1g/day) only minimally increased LpaC levels over a 1-year period.

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脂蛋白(a)胆固醇，随机OmegA -3脂肪酸补充和心血管事件：维生素D和OmegA -3试验的延长随访

背景/简介目前尚不清楚脂蛋白(a)胆固醇（LpaC），即脂蛋白(a) [Lp(a)]携带的胆固醇是否与心血管疾病（CVD）相关，类似于脂蛋白(a)质量或摩尔浓度，以及omega-3脂肪酸（n- 3fa）是否会改变风险。目的/目的我们假设LpaC患者；第75百分位人群分布的心血管事件发生率高于第75百分位人群分布的心血管事件发生率。补充n-3FA可能会改变这种风险。方法VITAL试验（NCT01169259）的13,175名参与者通过密度梯度超离心（Atherotec Diagnostics）测量基线LpaC，并检查是否发生CVD( = 701；平均随访9.8年)。在一组具有重复基线和1年LpaC的参与者（N =1639）中，我们还分析了随机N -3 FA （1g /d EPA+DHA）与安慰剂的效果。结果在未调整和调整的模型中，较高的基线LpaC水平与CVD风险增加没有显著关联（表）。无效应修饰(P interaction >；0.05)与n- 3fa、种族、性别或LDL-C有关。N-3 FA将基线时的中位LpaC从7 mg/dL （IQR, 5-10）增加到1年后的8 mg/dL [IQR， 5-10]（与安慰剂相比平均增加4.05%,p = 0.006，使用自然对数变换计算平均LpaC百分比变化）。在VITAL试验中，基线LpaC水平与CVD事件发生的高风险无关。此外，n-3脂肪酸补充（1g/天）在1年的时间内仅能最低限度地增加LpaC水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. Sections of Journal of clinical lipidology will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.