Persistence of HDL-related risk in patients with LDL-cholesterol levels < 70 mg/dL
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In a post hoc analysis on 9770 patients of the recently completed Treating to New Targets (TNT) study, the predictive relationship between HDL-cholesterol levels at the third month of treatment with statins and the time to the first major cardiovascular event was assessed as was the predictive value of HDL-cholesterol for specific LDL-cholesterol strata, including subjects with LDL-cholesterol levels below 70 mg/dL (1.8 mmol/L). Low HDL-cholesterol levels in patients receiving statins were predictive of major cardiovascular events, both when HDL-cholesterol was considered as a continuous variable and when subjects were stratified according to quintiles of HDL-cholesterol. This relationship was of borderline significance (P=0.05) after stratification according to LDL-cholesterol level in patients receiving statins. Even among subjects with LDL levels below 70 mg/dL, those in the highest quintile of HDL-cholesterol were at less risk for major cardiovascular events than those in the lowest quintile (P=0.03). In conclusion, the study results revealed that low HDL-cholesterol levels were predictive of major cardiovascular events in patients treated with statins, including those with LDL levels cholesterol levels below 70 mg/dL.
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