Low-Density Lipoprotein Cholesterol Time in Target Range and Clinical Outcomes in the General Population
Authors' conclusion
In the general population, higher LDL-C TTR was significantly associated with lower risks of adverse clinical outcomes.
Study context
- Population
- General population (ARIC study participants with ≥2 low-density lipoprotein cholesterol (LDL-C) measures between the first and fifth visits)
- Participants
- 8,813 participants
- Exposure
- LDL-C time in target range (TTR) 75%–100% vs 0%–25%
- Outcome
- MI, CVD, HF and stroke
Methodological detailslandmark analysis, competing risk analysis
- Landmark analysis
- Competing risk analysis
Main finding
As reported in the abstract
median 6.2 years
LDL-C TTR 75% to 100% vs LDL-C TTR 0% to 25%Hazard ratio (95% CI)
MI; 33.2% lower risk
0.668(0.539–0.829)
CVD; 33.8% lower risk
0.662(0.548–0.799)
HF; 15.3% lower risk
0.847(0.729–0.984)
Stroke; 23.7% lower risk
0.763(0.603–0.964)
- Myocardial infarction (MI) events
- 1,010
- Cardiovascular disease (CVD) events
- 1,308
- Heart failure (HF) events
- 1,863
- Stroke events
- 753
Observational data: associations, not effects.
Further findings
Risk prediction: adding LDL-C TTR to a conventional risk model (C statistic, NRI, IDI)
- MI: C statistic, NRI, IDI
- 0.70, 33.95%, and 1.01%
- CVD: C statistic, NRI, IDI
- 0.71, 35.42%, and 1.30%
- Significantly improved risk prediction
- P < 0.001
Original publication
Low-Density Lipoprotein Cholesterol Time in Target Range and Clinical Outcomes in the General Population. JACC Adv. Published 18 September 2025. doi:10.
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