Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Long-Term LDL-C and CV Mortality Risk

Circulation; ePub 2018 Aug 16; Abdullah, et al

Low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (HDL-C) ≥160 mg/dL were independently associated with a 50-80% increased relative risk of cardiovascular disease (CVD) mortality in a low 10-year risk cohort with long-term follow-up. The study sample included participants without a history of CVD or diabetes mellitus and defined as low risk (<7.5%) for 10-year atherosclerotic CVD events as baseline. The associations of fasting LDL-C and non-HDL-C with CVD mortality were tested with Cox proportional hazards models. Researchers found:

  • In 36,375 participants (72% men, median age 42 years) followed for a median of 26.8 years, 1,086 CVD and 598 coronary heart disease deaths occurred.
  • Compared with LDL-C <100 mg/dL, LDL-C categories 100 to 129 mg/dL, 130 to 159 mg/dL, 160 to 189.9 mg/dL, and ≥190 mg/dL were associated with a significantly higher risk of CVD death, with mean reductions in years free of CVD death of 1.8, 1.1, 4.3, and 3.9, respectively.
  • After adjustment for atherosclerotic CVD risk factors, LDL-C categories 160 to 189 mg/dL and ≥190 mg/dL remained independently associated with CVD mortality.
  • Using non-HDL-C <130 mg/dL as the reference, non-HDL-C 160 to 189 mg/dL, 190 to 219 mg/dL, and ≥220 mg/dL were significantly associated with CVD death.

Citation:

Abdullah SM, Defina LF, Leonard D, et al. Long-term association of low-density lipoprotein cholesterol with cardiovascular mortality in individuals at low 10-year risk of atherosclerotic cardiovascular disease. [Published online ahead of print August 16, 2018]. Circulation. doi:10.1161/CIRCULATIONAHA.118.03.

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