Observational studyClinical cardiology2015
Remnant Lipoprotein Cholesterol and Mortality After Acute Myocardial Infarction: Further Evidence for a Hypercholesterolemia Paradox From the TRIUMPH Registry.
Observational study in Clinical cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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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.
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.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Prognostic value of remnant cholesterol in patients with coronary heart disease: A systematic review and meta-analysis of cohort studies.Frontiers in cardiovascular medicine · 2022Pooled it
- Pooled it
- Article
- Remnant-Like Particle Cholesterol and the Risk of Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis.Journal of cardiovascular development and disease · 2022Review
- Mortality in patients with myocardial infarction and potential risk factors: A five-year data analysis.ARYA atherosclerosis · 2022Article
- The Association Between Hyperlipidemia and In-Hospital Outcomes in Takotsubo Cardiomyopathy.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Prognostic utility of triglyceride-rich lipoprotein-related markers in patients with coronary artery disease.Journal of lipid research · 2020Article
- Differential diagnostic factors of type 1 and type 2 myocardial infarction in patients with elevated cardiac troponin levels.Clinical and experimental emergency medicine · 2020Article
- Long-Term Prognostic Significance of High-Sensitive Troponin I Increase during Hospital Stay in Patients with Acute Myocardial Infarction and Non-Obstructive Coronary Arteries.Medicina (Kaunas, Lithuania) · 2020Observational
- The longitudinal association of remnant cholesterol with cardiovascular outcomes in patients with diabetes and pre-diabetes.Cardiovascular diabetology · 2020Article
- Association of hyperlipidaemia with 5-year survival after hospitalisation for acute myocardial infarction: a propensity score matched analysis.Open heart · 2020Observational
- Extended Serum Lipid Profile Predicting Long-Term Survival in Patients Treated for Abdominal Aortic Aneurysms.World journal of surgery · 2018Article
- Prediction models for different plaque morphology in non-significantly stenosed regions of saphenous vein grafts assessed with optical coherence tomography.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2018Article
- Potential of lipoproteins as biomarkers in acute myocardial infarction.Anatolian journal of cardiology · 2017Review
- Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies.Journal of the American Heart Association · 2016Observational
- Association of low-density lipoprotein pattern with mortality after myocardial infarction: Insights from the TRIUMPH study.Journal of clinical lipidologyArticle
Corrections and comments
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Authors and funding
12 authors at 9 institutions in 2 countries.
Funding
Abstract
backgroundRemnants are partially hydrolyzed, triglyceride-rich lipoproteins that, like other apolipoprotein B-containing lipoproteins, are atherogenic. Prior observational studies suggest paradoxically better outcomes in hypercholesterolemic patients who sustain an acute myocardial infarction (AMI), one of several known recurrent risk paradoxes. To date, the association of directly measured remnant lipoprotein cholesterol (RLP-C) with survival after an AMI has not been examined. HYPOTHESIS: Higher RLP-C levels may be paradoxically associated with lower mortality.
methodsWe examined 2465 AMI survivors in a prospective, 24-center US study of AMI outcomes. Lipoprotein cholesterol subfractions were directly measured by ultracentrifugation. RLP-C was defined as intermediate-density lipoprotein cholesterol (IDL-C) + very-low-density lipoprotein cholesterol subfraction 3 (VLDL3 -C). Given a linear relationship between RLP-C and mortality, we examined RLP-C by tertiles and continuously. Cox regression hazard ratios (HRs) were adjusted for the Global Registry of Acute Coronary Events (GRACE) score and 23 other covariates.
resultsParticipants were age 58 ± 12 years (mean ± SD), and 68% were men. After 2 years of follow-up, 226 (9%) participants died. The mortality proportion was 12.4% in the lowest tertile of RLP-C (0-15 mg/dL), 8.5% in the middle tertile (16-23 mg/dL), and 6.8% in the highest tertile (24-120 mg/dL; P < 0.001). A 1-SD increase in RLP-C (11 mg/dL) predicted a 24% lower adjusted risk of 2-year mortality (HR: 0.76, 95% confidence interval [CI]: 0.64-0.91). Similar results were found for a 1-SD increase in IDL-C (HR per 8 mg/dL: 0.80, 95% CI: 0.67-0.96), VLDL3 -C (HR per 4 mg/dL: 0.74, 95% CI: 0.61-0.89), and very-low-density lipoprotein cholesterol (VLDL-C; HR per 8 mg/dL: 0.69, 95% CI: 0.55-0.85).
conclusionsHigher RLP-C levels were associated with lower mortality 2 years after AMI despite rigorous adjustment for known confounders. Unknown protective factors or a lead-time bias likely explains the paradox.
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