Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management

Research output: Contribution to journalJournal articleResearchpeer-review

  • M John Chapman
  • Henry N Ginsberg
  • Pierre Amarenco
  • Felicita Andreotti
  • Jan Borén
  • Alberico L Catapano
  • Olivier S Descamps
  • Edward Fisher
  • Petri T Kovanen
  • Jan Albert Kuivenhoven
  • Philippe Lesnik
  • Luis Masana
  • Nordestgaard, Børge
  • Kausik K Ray
  • Zeljko Reiner
  • Marja-Riitta Taskinen
  • Lale Tokgözoglu
  • Tybjærg-Hansen, Anne
  • Gerald F Watts
  • European Atherosclerosis Society Consensus Panel
Even at low-density lipoprotein cholesterol (LDL-C) goal, patients with cardiometabolic abnormalities remain at high risk of cardiovascular events. This paper aims (i) to critically appraise evidence for elevated levels of triglyceride-rich lipoproteins (TRLs) and low levels of high-density lipoprotein cholesterol (HDL-C) as cardiovascular risk factors, and (ii) to advise on therapeutic strategies for management. Current evidence supports a causal association between elevated TRL and their remnants, low HDL-C, and cardiovascular risk. This interpretation is based on mechanistic and genetic studies for TRL and remnants, together with the epidemiological data suggestive of the association for circulating triglycerides and cardiovascular disease. For HDL, epidemiological, mechanistic, and clinical intervention data are consistent with the view that low HDL-C contributes to elevated cardiovascular risk; genetic evidence is unclear however, potentially reflecting the complexity of HDL metabolism. The Panel believes that therapeutic targeting of elevated triglycerides (= 1.7 mmol/L or 150 mg/dL), a marker of TRL and their remnants, and/or low HDL-C (
Original languageEnglish
JournalEuropean Heart Journal (English Edition)
Volume32
Issue number11
Pages (from-to)1345-61
Number of pages17
ISSN0195-668X
DOIs
Publication statusPublished - 2011

ID: 40184776