Evidence map›Paper›PMID 24980493›Full record

SynthesisEuropean heart journal2015

HDL cholesterol subclasses, myocardial infarction, and mortality in secondary prevention: the Lipoprotein Investigators Collaborative.

Seth S Martin, Arif A Khokhar, Heidi T May, Krishnaji R Kulkarni, Michael J Blaha, Parag H Joshi, Peter P Toth, Joseph B Muhlestein, Jeffrey L Anderson, Stacey Knight and 4 more

Abstract readMeta-AnalysisObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European heart journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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16 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Seth S MartinJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, 600 N. Wolfe St, Carnegie 565-G, Baltimore, 21287 MD, USA smart100@jhmi.edu.
Arif A KhokharSt Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
Heidi T MayCardiovascular Department, Intermountain Medical Center, Murray, UT, USA.
Krishnaji R KulkarniAtherotech Diagnostics Laboratory, Birmingham, AL, USA.
Michael J BlahaJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, 600 N. Wolfe St, Carnegie 565-G, Baltimore, 21287 MD, USA.
Parag H JoshiJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, 600 N. Wolfe St, Carnegie 565-G, Baltimore, 21287 MD, USA.
Peter P TothJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, 600 N. Wolfe St, Carnegie 565-G, Baltimore, 21287 MD, USA Department of Preventive Cardiology, CGH Medical Center, Sterling, IL, USA University of Illinois School of Medicine, Peoria, IL, USA.
Joseph B MuhlesteinCardiovascular Department, Intermountain Medical Center, Murray, UT, USA.
Jeffrey L AndersonCardiovascular Department, Intermountain Medical Center, Murray, UT, USA.
Stacey KnightCardiovascular Department, Intermountain Medical Center, Murray, UT, USA.
Yan LiSt Luke's Mid-America Heart Institute, University of Missouri - Kansas, Kansas City, MO, USA.
John A SpertusSt Luke's Mid-America Heart Institute, University of Missouri - Kansas, Kansas City, MO, USA.
Steven R JonesJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, 600 N. Wolfe St, Carnegie 565-G, Baltimore, 21287 MD, USA.
Lipoprotein Investigators Collaborative (LIC)

Funding

PATHOPHYSIOLOGY OF MYOCARDIAL DISEASEST32HL007227 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Chulan Kwon, WENDY S POST · 1985 to 2026
$21.2M
CARDIOVASCULAR EPIDEMIOLOGY INSTITUTIONAL TRAININGT32HL007024 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Elizabeth Selvin · 1985 to 2026
$17.5M
SCCOR in Cardiac Dysfunction and DiseaseP50HL077113 · NHLBI · WASHINGTON UNIVERSITY · PI KELLY, DANIEL PATRICK · 2005 to 2009
$13.4M
NHLBI NIH HHS P50 HL 077113NHLBI NIH HHS T32 HL007227NHLBI NIH HHS T32HL007227NHLBI NIH HHS T32HL07024
6 · The paper itself

Abstract

aimsHigh-density lipoprotein (HDL) is highly heterogeneous and the link of its subclasses to prognosis remains controversial. We aimed to rigorously examine the associations of HDL subclasses with prognosis in secondary prevention. METHODS AND

resultsWe collaboratively analysed data from two, complementary prospective cohorts: the TRIUMPH study of 2465 acute myocardial infarction patients, and the IHCS study of 2414 patients who underwent coronary angiography. All patients had baseline HDL subclassification by vertical-spin density gradient ultracentrifugation. Given non-linearity, we stratified by tertiles of HDL-C and its two major subclasses (HDL2-C, HDL3-C), then compared multivariable-adjusted hazard ratios for mortality and mortality/myocardial infarction. Patients were middle-aged to elderly (TRIUMPH: 58.2 ± 12.2 years; IHCS: 62.6 ± 12.6 years), and the majority were men (TRIUMPH: 68.0%; IHCS: 65.5%). IHCS had lower mean HDL-C levels (34.6 ± 10.1 mg/dL) compared with TRIUMPH (40 ± 10.6 mg/dL). HDL3-C accounted for >3/4 of HDL-C (mean HDL3-C/HDL-C 0.78 ± 0.05 in both cohorts). During 2 years of follow-up in TRIUMPH, 226 (9.2%) deaths occurred, while death/myocardial infarction occurred in 401 (16.6%) IHCS patients over 5 years. No independent associations with outcomes were observed for HDL-C or HDL2-C. In contrast, the lowest tertile of HDL3-C was independently associated with >50% higher risk in each cohort (TRIUMPH: with middle tertile as reference, fully adjusted HR for mortality of HDL3-C, 1.57; 95% CI, 1.13-2.18; IHCS: fully adjusted HR for mortality/myocardial infarction, 1.55; 95% CI, 1.20-2.00).

conclusionIn secondary prevention, increased risk for long-term hard clinical events is associated with low HDL3-C, but not HDL2-C or HDL-C, highlighting the potential value of subclassifying HDL-C.

Indexed as

AgedCholesterol, HDLCoronary DiseaseFemaleHumansMaleMiddle AgedMyocardial InfarctionPrognosisProspective StudiesRisk AssessmentSecondary PreventionUltracentrifugationCholesterol, HDLAcute myocardial infarctionCoronary heart diseaseHDL2HDL3HDL subclassesHigh-density lipoprotein cholesterolLipidsMortalitySecondary prevention

Identifiers

PMID24980493
PMCPMC4286318

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.