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dc.contributor.authorMaki, Kevin C.
dc.contributor.authorGuyton, John R.
dc.contributor.authorOrringer, Carl E.
dc.contributor.authorHamilton-Craig, Ian
dc.contributor.authorAlexander, Dominik D.
dc.contributor.authorDavidson, Michael H.
dc.date.accessioned2019-03-28T23:21:31Z
dc.date.available2019-03-28T23:21:31Z
dc.date.issued2016
dc.identifier.issn1876-4789en_US
dc.identifier.doi10.1016/j.jacl.2016.03.008en_US
dc.identifier.urihttp://hdl.handle.net/10072/100535
dc.description.abstractBackground: Cardiovascular outcomes trials of fibrates, niacin, or omega-3 fatty acids alone, or added to a statin, have not consistently demonstrated reduced risk, but larger, statistically significant clinical benefits have been reported in subgroups with elevated triglycerides (TG) and/or elevated TG plus low high-density lipoprotein cholesterol (HDL-C). Objective: To perform a meta-analysis of the effects of therapies targeting TG and TG-rich lipoprotein cholesterol on cardiovascular disease event risk in subjects with elevated TG or elevated TG paired with low HDL-C. Methods: Publications were identified using PubMed, the Cochrane Central Register of Controlled Trials, clinicaltrials.gov, the World Health Organization International Clinical Trials Registry Platform, and Internet Stroke Center. Random-effects meta-analysis models were used to generate summary relative risk estimates and 95% confidence intervals. Heterogeneity was assessed by χ2 and I2 statistics, and the impact of each trial was assessed in one study–removed sensitivity analyses. Results: Six trials of fibrates, 2 of niacin, 1 of fibrate + niacin, and 1 of omega-3 eicosapentaenoic acid ethyl esters were identified. For the prespecified primary cardiovascular disease or coronary heart disease end point used in each trial, the summary relative risk estimate (95% confidence interval) for subjects with elevated TG was 0.82 (0.73–0.91), p-heterogeneity = 0.13, I2 = 36.2, and for subjects with elevated TG and low-HDL-C, it was 0.71 (0.63–0.81), p-heterogeneity = 0.52, I2 = 0.0. There was no evidence of publication bias, and the results remained statistically significant when each individual trial was removed. Conclusion: Drugs that substantially, but not exclusively, lower TG and TG-rich lipoprotein cholesterol may have cardiovascular benefits in individuals with elevated TG, particularly if accompanied by low HDL-C.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherElsevieren_US
dc.relation.ispartofpagefrom905en_US
dc.relation.ispartofpageto914en_US
dc.relation.ispartofissue4en_US
dc.relation.ispartofjournalJournal of Clinical Lipidologyen_US
dc.relation.ispartofvolume10en_US
dc.subject.fieldofresearchMedical Biochemistry and Metabolomics not elsewhere classifieden_US
dc.subject.fieldofresearchcode110199en_US
dc.titleTriglyceride-lowering therapies reduce cardiovascular disease event risk in subjects with hypertriglyceridemiaen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.hasfulltextNo Full Text


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