Prevention & lipidsCohort study
Prediction of Cumulative Exposure to Atherogenic Lipids During Early Adulthood
- Prospective cohort study
Authors' conclusion
Single measures of non-HDL-C and LDL-C obtained between ages 18 and 30 years are highly predictive of cumulative exposure before age 40 years, which in turn strongly predicts later-life ASCVD events.
Study context
- Population
- CARDIA participants free of CVD before age 40 years, not on lipid-lowering medications, with ≥3 low-density lipoprotein cholesterol (LDL-C) and non-HDL-C measurements before age 40 yearsof 4,104 CARDIA participants
- Participants
- 3,995 participants
- Exposure
- Single non-HDL-C or LDL-C measurement at age 18–30 years to predict cumulative exposure ages 18–40 years; cumulative exposure quartiles and atherosclerotic cardiovascular disease (ASCVD) after age 40 years
Main finding
As reported in the abstract
Prediction of top or bottom quartile of cumulative exposure by a 1-time non-HDL-C or LDL-C measure
- AUC for the 4 models (excellent discrimination)
- 0.93
- Cut-off predicting top quartile, non-HDL-C (highest Youden's Index)
- >135 mg/dL
- Cut-off predicting top quartile, LDL-C (highest Youden's Index)
- >118 mg/dL
- Cut-off predicting bottom quartile, non-HDL-C
- <107 mg/dL
- Cut-off predicting bottom quartile, LDL-C
- <96 mg/dL
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| ASCVD events (fatal and nonfatal MI and stroke) after age 40 years, by cumulative exposure quartile — Top quartile vs Bottom quartile · non-HDL-C; demographic-adjusted | 4.6 (2.84–7.29) | |
| ASCVD events (fatal and nonfatal MI and stroke) after age 40 years, by cumulative exposure quartile — Top quartile vs Bottom quartile · LDL-C; demographic-adjusted | 4.0 (2.50–6.33) | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Prediction of Cumulative Exposure to Atherogenic Lipids During Early Adulthood. J Am Coll Cardiol. Published 10 September 2024. doi:10.1016/j.jacc.2024.05.070
Summarised from the published abstract; every number is checked against it