Associations of HDL-C/LDL-C with myocardial infarction, all-cause mortality, haemorrhagic stroke and ischaemic stroke: a longitudinal study based on 384 093 participants from the UK Biobank

Yuan, Shiqi; Huang, Xiaxuan; Ma, Wen; Yang, Rui; Xu, Fengshuo; Han, Didi; Peng, MIn; Xu, Anding; Lyu, Jun

doi:10.1136/svn-2022-001668

Cited by 20 publications

(11 citation statements)

References 41 publications

(56 reference statements)

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“…Previous studies were based on the results of the FOURIER trial, which estimated the risk of various outcomes based on intervention strategies that lowered LDL-C values (15). However, the latest evidence suggests that LDL-C values do not have a linear relationship with clinical risk (38;39). Our finding is in line with previous reports but provides additional information with updated estimates (37).…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of adding ezetimibe and/or PCSK9 inhibitors to high-dose statins for secondary prevention of cardiovascular disease in Chinese adults

Xiang,

Gan,

et al. 2023

Int J Technol Assess Health Care

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Objectives The latest international guideline recommended the add-on therapy of ezetimibe and PCSK9 inhibitors in selected people for the secondary prevention of cardiovascular diseases (CVDs). However, it remains unclear whether these regimens fit the Chinese healthcare system economically. Methods Based on the Chinese context, this simulation study evaluated four therapeutic strategies including the high-dose statin-only group, ezetimibe plus statin group, PCSK9 inhibitors plus statin group, and PCSK9 inhibitors plus ezetimibe plus statin group. The team developed a Markov model to estimate the incremental cost-effectiveness ratio (ICER). With each 1-yr cycle, the simulation subjects could have nonfatal cardiovascular events (stroke and/or myocardial infarction) or death (vascular or nonvascular death event) with a follow-up duration of 20 yr. Cardiovascular risk reduction was gathered from a network meta-analysis, and cost and utility data were gathered from hospital databases and published research. Results For Chinese adults receiving high-dose statins for secondary prevention of CVDs, the ICER was US$68,910 per quality-adjusted life year (QALY) for adding PCSK9 inhibitors, US$20,242 per QALY for adding ezetimibe, US$51,552 per QALY for adding both drugs. Given a threshold of US$37,655 (three times of Chinese GDP), the probability of cost-effectiveness is 2.9 percent for adding PCSK9 inhibitors, 53.1 percent for adding ezetimibe, and 16.8 percent for adding both drugs. To meet the cost-effectiveness, an acquisition price reduction of PCSK9 inhibitors of 33.6 percent is necessary. Conclusion In Chinese adults receiving high-dose statins for the secondary prevention of CVDs, adding ezetimibe is cost-effective compared to adding PCSK9 inhibitors and adding both drugs.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of adding ezetimibe and/or PCSK9 inhibitors to high-dose statins for secondary prevention of cardiovascular disease in Chinese adults

Xiang,

Gan,

et al. 2023

Int J Technol Assess Health Care

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“…The UK Biobank is a substantial research cohort consisting of over 500 000 individuals enrolled in the United Kingdom between 2006 and 2010. These participants underwent baseline assessments, including physical, sociodemographic, and medical evaluations ( 20 , 21 ). Starting in 2014, the UK Biobank initiated magnetic resonance imaging (MRI), including brain imaging, with the goal of gathering imaging data from 100 000 participants.…”

Section: Methodsmentioning

confidence: 99%

Associations of Folate/Folic Acid Supplementation Alone and in Combination With Other B Vitamins on Dementia Risk and Brain Structure: Evidence From 466 224 UK Biobank Participants

Ling,

Yuan,

Huang

et al. 2023

The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences

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Previous researchers have tried to explore the association between folate/folic acid intake and dementia incidence, but the results remain controversial. We evaluated the associations of folate/folic acid supplementation alone and in combination with other B vitamins on dementia risk and brain structure. A total of 466,224 UK Biobank participants were investigated. Cox proportional hazards models were used to assess the associations between folate/folic acid supplementation status and the risk of Alzheimer's disease (AD) and vascular dementia (VD). Multivariable linear regression models were employed to evaluate the association between folate/folic acid supplementation status and brain structure. In the final model, folate/folic acid supplementation alone was significantly associated with a higher risk of AD (hazard ratio [HR] =1.34, 95% confidence interval [CI] =1.06 to 1.69, p=0.015) and VD (HR=1.61, 95% CI=1.21 to 2.13, p=0.001). Folate/folic acid supplementation alone was associated with a reduction in the hippocampus (β= -95.25 mm3, 95% CI= -165.31 to -25.19 mm3, p=0.014) and amygdala (β= -51.85 mm3, 95% CI= -88.02 to -15.68 mm3, p=0.012). The risk of AD and VD, as well as brain structure, in the group with combined folate/folic acid supplementation and other B vitamins did not show a statistically significant difference compared to the reference group (all p>0.05). Folate/folic acid supplementation alone is significantly associated with a higher risk of AD and VD, as well as adverse alterations in brain structure. However, when combined with other B vitamins, these detrimental effects can be counteracted.

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Section: Introductionmentioning

confidence: 99%

“…Disorders of lipoprotein metabolism named dyslipidemia are thought to be the one of most important risk factors for MI 3 . Elevated level of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and the high ratio of LDL-C to high-density lipoprotein cholesterol (HDL-C) increased the risk of MI 4-6 . The atherogenic index of plasma (AIP) is calculated as log (TG/HDL) and reflects the levels of TG and HDL-C cholesterol, which is considered a potential biomarker of MI 7-10 .…”

Section: Introductionmentioning

confidence: 99%

Atherogenic index of plasma is associated with the risk of myocardial infarction: a prospective cohort study

Zhang

Wang

Tian

et al. 2023

Preprint

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Background and aims The atherogenic index of plasma (AIP) has been confirmed as a contributor of cardiovascular disease. But few evidence on the longitudinal pattern of AIP during follow-up. This study aimed to explore the associations between baseline and long-term AIP with the risk of myocardial infarction (MI). Methods A total of 98 861 participants without MI at baseline were included from the Kailuan study. The baseline AIP was calculated as log (triglyceride/high-density lipoprotein cholesterol). The long-term AIP was calculated as the updated mean AIP and the number of visits with high AIP. The updated mean AIP was calculated as the mean of AIP from baseline to the first occurrence of MI or to the end of follow-up. The number of visits with high AIP was defined as higher than the cutoff value at the first three visits. Univariable and multivariable Cox proportional hazard models were used to determine the association between AIP and the risk of MI. Results During a median follow-up of 12.80 years, 1804 participants developed MI. The multivariable models revealed that elevated levels of baseline and updated mean AIP increased the risk of MI, compared with quartile 1 the HR in quartile 4 was 1.63 (95% CI, 1.41-1.88) and 1.59 (95% CI, 1.37-1.83), respectively. Compared to those without high AIP, the risk of individuals with three times was 1.94 (95% CI,1.55-2.45). Conclusions Elevated levels of both baseline and long-term AIP displayed a higher risk of MI.

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Associations of HDL-C/LDL-C with myocardial infarction, all-cause mortality, haemorrhagic stroke and ischaemic stroke: a longitudinal study based on 384 093 participants from the UK Biobank

Cited by 20 publications

References 41 publications

Cost-effectiveness of adding ezetimibe and/or PCSK9 inhibitors to high-dose statins for secondary prevention of cardiovascular disease in Chinese adults

Cost-effectiveness of adding ezetimibe and/or PCSK9 inhibitors to high-dose statins for secondary prevention of cardiovascular disease in Chinese adults

Associations of Folate/Folic Acid Supplementation Alone and in Combination With Other B Vitamins on Dementia Risk and Brain Structure: Evidence From 466 224 UK Biobank Participants

Atherogenic index of plasma is associated with the risk of myocardial infarction: a prospective cohort study

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