Author + information
- Shuaib Abdullah,
- David Leonard,
- Jarett Berry,
- Benjamin Willis,
- Laura Defina,
- Darren McGuire,
- James de Lemos and
- Amit Khera
Although the association of LDL cholesterol (LDL-C) with cardiovascular disease (CVD) mortality is well established in intermediate and high risk populations, less is known in subjects with low CVD risk.
Fasting LDL-C was measured in participants of the Cooper Center Longitudinal Study, from 1978 and 1998, who were defined as low risk for 10-year CVD events based on Adult Treatment Panel III guidelines (0 or 1 major risk factors). The association of LDL-C categories with CVD mortality, ascertained from the National Death Index, was tested by Cox proportional hazards models.
In 24,503 participants (69% men, median age 40) followed for a median of 19.3 years, 214 CVD deaths occurred. Compared with the reference group of LDL-C < 100 mg/dL, a significant association was seen between LDL-C groups 130-159.9 mg/dL, 160-189.9 mg/dL, and ≥ 190 mg/dL and CVD death (Table). After adjustment for sex, HDL-C, tobacco use, hypertension, and family history of coronary heart disease, the 2 highest LDL-C groups remained significantly associated. Of all subjects who died (n=902), the proportion of CVD deaths increased in a stepwise fashion from 12.3% in LDL-C <100 to 39.7% in the LDL-C >190mg/dl group.
In a low risk population with long term follow-up, LDL-C levels ≥ 130mg/dL in unadjusted analysis, and ≥ 160mg/dL in adjusted analysis, were associated with CVD risk. These findings underscore the importance of extending CVD risk prediction beyond the 10 year horizon in low risk individuals.
|LDL cholesterol (mg/dL)||n||Unadjusted HR [95% CI] for CVD Mortality||Adjusted HR [95% CI] for CVD Mortality|
|< 100||4983||Reference Group||Reference Group|
|100–129.9||8320||1.6 [0.9–2.7]||1.3 [0.8–2.3]|
|130–159.9||6750||1.8 [1.0–3.1]||1.4 [0.8–2.5]|
|160–189.9||3138||3.0 [1.7–5.3]||2.3 [1.3–4.1]|
|≥ 190||1393||2.6 [1.4–5.0]||2.0 [1.0–3.9]|
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: Lipoproteins, Particles and Ratios
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1145-7
- 2013 American College of Cardiology Foundation