The predictive role of atherogenic dyslipidemia in subjects with non-coronary atherosclerosis.

Background: Recent findings have suggested that subjects with non-coronary atherosclerosis may show elevated prevalence of atherogenic dyslipidemia, including higher triglyceride levels, reduced HDL-cholesterol concentrations and increased levels of small, dense low-density lipoproteins (LDL). These three lipid abnormalities constitute the so-called "atherogenic-lipoprotein-phenotype" (ALP) but its predictive role in these patients still remains to be established.
Methods: We performed a 2-year follow-up study to assess clinical and biochemical predictors of cardiovascular events in 44 male patients (64+/-5 years, BMI: 27+/-3), 26 with peripheral arterial disease and 18 with abdominal aortic aneurysm. Beyond traditional cardiovascular risk factors, we measured LDL size and subclasses by gradient gel electrophoresis.
Results: Clinical events were registered in the 43% of patients. At univariate analysis we found that patients with events had increased prevalence of hypertension (p=.0098), diabetes (p=.0089), family history of cardiovascular diseases (p=.0089), of elevated small, dense LDL (p=.0222) and ALP (p=.0224). At multivariate analysis (including all clinical and laboratory variables) we found the following independent predictors of events: hypertension (OR 8.9, p=.0347), diabetes (OR 9.4, p=.0270), elevated small, dense LDL (OR 6.9, p=.0488) and ALP (OR 8.7, p=.0497).
Conclusions: This is the first study that evaluated the predictive role of ALP beyond traditional cardiovascular risk factors in patients with peripheral arterial disease or abdominal aortic aneurysm. We confirmed that hypertension and diabetes are strong predictors of cardiovascular events in these subjects but ALP seems to be an independent predictor too. Yet, the therapeutical consequences of these findings need to be tested by future studies.