Trial reportJournal of the American College of Cardiology2015
Relationship of oxidized phospholipids on apolipoprotein B-100 to cardiovascular outcomes in patients treated with intensive versus moderate atorvastatin therapy: the TNT trial.
Trial report in Journal of the American College of Cardiology, 2015. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but it casts no vote: the report of the main result of NCT00327691 is not on the map. It reports registered trial NCT00327691. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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In the atorvastatin 10-mg group, tertile 3 was associated with a higher risk of MACE compared to the first tertile (HR: 2.08; 95% CI: 1.20 to 3.61; p = 0.01) but this was not significant in the atorvastatin 80-mg group (HR: 1.40; 95% CI: 0.80 to 2.46; p = 0.24).
In the atorvastatin 10-mg group, tertile 3 was associated with a higher risk of MACE compared to the first tertile (HR: 2.08; 95% CI: 1.20 to 3.61; p = 0.01) but this was not significant in the atorvastatin 80-mg group (HR: 1.40; 95% CI: 0.80 to 2.46; p = 0.24).
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Where it lands on the map
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What it adds to each cell
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Statins×cardiovascular events
No readable resultOpen on the map →What to test next →29 readable studies in this cell: 16 favour the treatment, 11 find no difference, 2 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
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.
The Effect Of LDL-Cholesterol, Lowering Beyond Currently Recommended Minimum Targets On Coronary Heart Disesse (CHD) Recurrence In Patients With Pre-Existing CHD
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Low-Density Lipoprotein Cholesterol Corrected for Lipoprotein(a) Cholesterol, Risk Thresholds, and Cardiovascular Events.Journal of the American Heart Association · 2020Pooled it
- Lipoprotein(a) and oxidized phospholipids are associated with myocardial inflammation after acute myocardial infarction.Nature cardiovascular research · 2026Trial
- On-treatment platelet reactivity through the thromboxane AJournal of thrombosis and thrombolysis · 2023Trial
- Oxidized Phospholipids on Lipoprotein(a) Elicit Arterial Wall Inflammation and an Inflammatory Monocyte Response in Humans.Circulation · 2016Trial
- Acute and long-term effect of percutaneous coronary intervention on serially-measured oxidative, inflammatory, and coagulation biomarkers in patients with stable angina.Journal of thrombosis and thrombolysis · 2016Trial
- Reduction in lipoprotein-associated apoC-III levels following volanesorsen therapy: phase 2 randomized trial results.Journal of lipid research · 2016Trial
- Lipoprotein(a)-cholesterol levels estimated by vertical auto profile correlate poorly with Lp(a) mass in hyperlipidemic subjects: Implications for clinical practice interpretation of Lp(a)-mediated risk.Journal of clinical lipidologyTrial
- Elevated lipoprotein(a) and adverse outcomes in advanced coronary artery calcification: An intravascular ultrasound study.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Association of lipoprotein(a), oxidized phospholipids and apolipoprotein B100 in acute ischemic stroke cohort.Advances in lipoprotein(a) research · 2026Article
- Eicosapentaenoic acid limits the more rapid oxidation of lipoprotein(a) compared with other apolipoprotein B particles.Cardiovascular research · 2025Article
- Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease.Journal of lipid research · 2025Article
- Apolipoprotein B-containing lipoproteins in atherogenesis.Nature reviews. Cardiology · 2025Review
- Lipoprotein(a), platelet function and cardiovascular disease.Nature reviews. Cardiology · 2024Review
- Oxidized phospholipids in cardiovascular disease.Nature reviews. Cardiology · 2024Review
- Clot or Not? Reviewing the Reciprocal Regulation Between Lipids and Blood Clotting.Arteriosclerosis, thrombosis, and vascular biology · 2024Review
- Does Elevated High-Density Lipoprotein Cholesterol Protect Against Cardiovascular Disease?The Journal of clinical endocrinology and metabolism · 2024Article
- Phospholipids, the Masters in the Shadows during Healing after Acute Myocardial Infarction.International journal of molecular sciences · 2023Review
- Lp(a), oxidized phospholipids and oxidation-specific epitopes are increased in subjects with keloid formation.Lipids in health and disease · 2022Article
- Phospholipid Membrane Transport and Associated Diseases.Biomedicines · 2022Review
- Atherothrombotic factors and atherosclerotic cardiovascular events: the multi-ethnic study of atherosclerosis.European heart journal · 2022Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
The marked sentences are the ones the graph read a number from.
backgroundOxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) is a biomarker of increased risk for major adverse cardiovascular events (MACE) in community cohorts, but its role in patients with stable coronary heart disease (CHD) is unknown.
objectivesThis study sought to examine the relationship between these oxidative biomarkers and cardiovascular outcomes in patients with established CHD.
methodsIn a random sample from the TNT (Treating to New Targets) trial, OxPL-apoB levels were measured in 1,503 patients at randomization (after an 8-week run-in period taking atorvastatin 10 mg) and 1 year after being randomized to atorvastatin 10 or 80 mg. We examined the association between baseline levels of OxPL-apoB and MACE, defined as death from CHD, nonfatal myocardial infarction, resuscitation after cardiac arrest, and fatal/nonfatal stroke, as well as the effect of statin therapy on OxPL-apoB levels and MACE.
resultsPatients with events (n = 156) had higher randomization levels of OxPL-apoB than those without events (p = 0.025). For the overall cohort, randomization levels of OxPL-apoB predicted subsequent MACE (hazard ratio [HR]: 1.21; 95% confidence interval: 1.04 to 1.41; p = 0.018) per doubling and tertile 3 versus tertile 1 (hazard ratio: 1.69; 95% confidence interval [CI]: 1.14 to 2.49; p = 0.01) after multivariate adjustment for age, sex, body mass index, among others, and treatment assignment. In the atorvastatin 10-mg group, tertile 3 was associated with a higher risk of MACE compared to the first tertile (HR: 2.08; 95% CI: 1.20 to 3.61; p = 0.01) but this was not significant in the atorvastatin 80-mg group (HR: 1.40; 95% CI: 0.80 to 2.46; p = 0.24).
conclusionsElevated OxPL-apoB levels predict secondary MACE in patients with stable CHD, a risk that is mitigated by atorvastatin 80 mg. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691).
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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.