Baseline serum cholestanol can predict recurrent coronary events
A major Scandinavian study has shown that recurrent major coronary
events in patients with coronary heart disease cannot be predicted by
baseline concentrations of total and low density lipoprotein
cholesterol alone. On p 1127 Miettinen et al report a study of such
patients who were treated with simvastatin, which decreases synthesis
of cholesterol. They found that the lowest baseline quarter of
cholestanol:cholesterol ratio was associated with significantly reduced
relative risk of major coronary events, while the risk in the highest
quarter was unchanged and over two times higher. The serum ratios of
cholestanol were related inversely to the body mass index and directly
to high density lipoprotein cholesterol and triglyceride concentrations
but were not related to risk reduction. The authors suggest that
patients with high absorption (high baseline cholestanol:cholesterol)
and low synthesis of cholesterol do not benefit from statin treatment
alone and that such patients can be defined by measurement of
cholestanol before treatment.
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- Baseline serum cholestanol as predictor of recurrent coronary events in subgroup of Scandinavian simvastatin survival study
- Tatu A Miettinen, Helena Gylling, Timo Strandberg, and Seppo Sarna
BMJ 1998 316: 1127-1130.[Abstract] [Full Text] [PDF]
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