Non-HDL Cholesterol Levels Linked to Long-Term ASCVD Risk

Elevated concentrations of non-high-density lipoprotein (non-HDL) cholesterol are associated with an increased long-term risk for atherosclerotic cardiovascular disease, according to a study published online in The Lancet.

Fabian J. Brunner, M.D., from the University Heart & Vascular Center Hamburg in Germany, and colleagues examined the cardiovascular disease risk associated with the spectrum of bloodstream non-HDL cholesterol concentrations. In addition, a tool was created to estimate the probabilities of a cardiovascular disease event by age 75 years.

A total of 398,846 individuals belonging to 38 cohorts were identified; the derivation and validation cohorts included 199,415 and 199,431 individuals, respectively. The researchers identified 54,542 cardiovascular end points during a maximum follow-up of 43.6 years. For increasing HDL cholesterol categories, incidence curve analyses showed progressively higher 30-year cardiovascular disease event rates. For both sexes, in multivariable analysis with non-HDL cholesterol lower than 2.6 mmol/L as reference, there was an increase noted in the association between non-HDL cholesterol concentration and cardiovascular disease. Cardiovascular disease event probabilities specific for non-HDL cholesterol could be estimated with the derived tool, with high comparability seen between the derivation and validation cohorts. A 50 percent decrease in non-HDL cholesterol concentration correlated with reduced cardiovascular disease event risk by age 75 years; the risk reduction was greater with earlier reductions in cholesterol concentrations.

"Our study provides unique insights into the benefits of a potential early intervention in primary prevention," the authors write.

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