Low-Density Lipoprotein Cholesterol Is Predominantly Associated With Atherosclerotic Cardiovascular Disease Events in Patients With Evidence of Coronary Atherosclerosis: The Western Denmark Heart Registry
Authors' conclusion
LDL-C appears to be almost exclusively associated with ASCVD events over ≈5 years of follow-up in middle-aged individuals with versus without evidence of coronary atherosclerosis.
Study context
- Population
- Consecutive symptomatic patients evaluated for CAD with coronary CT angiography, Western Denmark Heart Registry552 first atherosclerotic cardiovascular disease (ASCVD) events
- Participants
- 23,132 patients
- Exposure
- Low-density lipoprotein cholesterol (LDL-C) and ASCVD events by coronary artery calcification (CAC)>0 vs CAC=0
- CAC>0n = 10,792
- CAC=0n = 12,340
- Outcome
- ASCVD events per 38.7 mg/dL LDL-C increase, by CAC
Methodological detailsmulticentre, consecutive patients, replication in MESA
- Multicentre
- Consecutive patients
- Replication in MESA
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)
CAC>0
1.18(1.06–1.31)
CAC=0
1.02(0.87–1.18)
Per 38.7 mg/dL LDL-C increase, as printed
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| ASCVD events per 38.7 mg/dL LDL-C increase, overall population | 1.14 (1.04–1.24) | |
| 0.512Adjusted hazard ratio (log scale) |
ASCVD events, LDL-C >193 mg/dL vs <116 mg/dL, by CAC
| aHR (95% CI) | ||
|---|---|---|
| CAC>0LDL-C >193vs <116 mg/dL | 2.42 (1.59–3.67) | |
| CAC=0LDL-C >193vs <116 mg/dL | 0.92 (0.48–1.79) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Other risk factors in CAC=0
- In CAC=0, DM, current smoking and low HDL-C associated with future ASCVD events
Replication in MESA
- Principal findings replicated in the Multi-Ethnic Study of Atherosclerosis
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Low-Density Lipoprotein Cholesterol Is Predominantly Associated With Atherosclerotic Cardiovascular Disease Events in Patients With Evidence of Coronary Atherosclerosis: The Western Denmark Heart Registry. Circulation. Published 9 January 2023. doi:10.
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