Atherogenic dyslipidemia was independently associated with a significantly increased risk of silent coronary artery disease (OR 4.0) in asymptomatic patients with type 2 diabetes and LDL cholesterol <3.35 mmol/L.
Cross-Sectional (n=1,080)
Yes
Does atherogenic dyslipidemia increase the risk of silent myocardial ischemia and silent coronary artery disease in asymptomatic patients with type 2 diabetes?
Effect estimate: OR 4.0 (95% CI 1.7-9.2)
p-value: p=<0.001
BACKGROUND: To investigate whether atherogenic dyslipidemia, a dyslipidemic profile combining elevated triglycerides and low high-density lipoprotein (HDL) cholesterol, is predictive of risk of silent myocardial ischemia (SMI) or angiographic coronary artery disease (CAD) in asymptomatic patients with type 2 diabetes. METHODS: Cohort study in 1080 asymptomatic patients with type 2 diabetes with a normal resting electrocardiogram, at least one additional cardiovascular risk factor and low density lipoprotein (LDL) cholesterol <3.35 mmol/L. Patients initially underwent screening for SMI by stress myocardial scintigraphy. Patients with SMI underwent coronary angiography. RESULTS: Overall, 60 (5.5 %) patients had atherogenic dyslipidemia (triglycerides ≥2.26 mmol/L and HDL cholesterol ≤0.88 mmol/L). In multivariate analyses taking into account the parameters associated in univariate analyses with SMI and then CAD, atherogenic dyslipidemia was associated with SMI (odds ratio 1.81.0-3.3), as were male gender (OR 2.11.5-2.9), BMI (OR 0.970.94-0.997), retinopathy (OR 1.41.1-1.9), peripheral occlusive arterial disease (POAD: OR 2.51.6-3.8) and mean blood pressure (OR 1.011.00-1.03); atherogenic dyslipidemia was associated with CAD (OR 4.01.7-9.2), as were male gender (OR 3.01.6-5.6), BMI (OR 0.940.90-0.995), retinopathy (OR 1.71.0-2.9, POAD (OR 4.02.1-7.4) and mean blood pressure (OR 1.031.01-1.05). In the subgroup of 584 patients with LDL cholesterol <2.6 mmol/L, atherogenic dyslipidemia was also associated with CAD (OR 3.61.5-9.0). CONCLUSIONS: Atherogenic dyslipidemia was associated with an increased risk of SMI and silent CAD in patients with type 2 diabetes and LDL cholesterol levels <3.35 mmol/L. Specific management of atherogenic dyslipidemia might help reducing the high residual burden of cardiovascular disease.
Valensi et al. (Fri,) conducted a cross-sectional in Type 2 diabetes (n=1,080). Atherogenic dyslipidemia vs. No atherogenic dyslipidemia was evaluated on Silent coronary artery disease (CAD) (OR 4.0, 95% CI 1.7-9.2, p=<0.001). Atherogenic dyslipidemia was independently associated with a significantly increased risk of silent coronary artery disease (OR 4.0) in asymptomatic patients with type 2 diabetes and LDL cholesterol <3.35 mmol/L.