Abstract 19139: Effect of HDL-C Raising and/or Triglyceride Lowering on Cardiovascular Outcomes and All-Cause Mortality in the AIM-HIGH Trial

Background: Published reports have questioned the benefit of serum HDL-cholesterol (HDL-C) raising and/or triglycerides (TG) lowering for patients at risk for cardiovascular (CV) events. Methods: AIM-HIGH (NCT00120289) patient-level data were reanalyzed to evaluate the effects of HDL-C raising and TG lowering treatment strategies (background statin ± extended-release niacin therapy) on major adverse CV events (MACE: a composite of MI, stroke, and CV death) and all-cause mortality. Four groups, based on percent change from baseline to 6 months in HDL-C and TG due to antidyslipidemic therapy, were compared (Table 1). Time-to-first event analyses were performed, with a multivariate analysis used to adjust for group, age, gender, history of diabetes, and estimated glomerular filtration rate [eGFR]. Results: Kaplan-Meier curves showed a significant difference for MACE (log-rank pu003c0.05) among the four groups (Figure 1). Surprisingly, a 49%-increased risk of MACE (unadjusted HR 1.49; 95% CI 1.14 to 1.98, pu003c0.01)...