Cumulative non-high-density lipoprotein cholesterol burden and risk of atherosclerotic cardiovascular disease: a prospective community-based study

Abstract

BackgroundThe relationship between cumulative non-high-density lipoprotein cholesterol (non-HDL-C) burden and atherosclerotic cardiovascular disease (ASCVD) remains unclearObjectiveTo prospectively examine the association between cumulative non-HDL-C burden and ASCVD risk in the Kailuan cohort of China.MethodsA total of 49,679 subjects who were free of ASCVD participated in three consecutive examinations in 2006, 2008 and 2010 were enrolled. Duration and concentration of cumulative exposure to non-HDL-C (cumNon-HDL-C) were respectively used to estimate the extent of cumulative non-HDL-C burden. The participants were divided into four groups according to durations of cumNon-HDL-C (0, 2, 4 and 6 years) and five groups according to the quintiles of cumNon-HDL-C concentration (<10.93, 10.93–12.68, 12.69–14.32, 14.33–16.72 and ≥16.73 mmol/L). Cox regression models were used to analyze the influence of cumulative non-HDL-C burden on ASCVD risk.ResultsWe identified 1,134 incident ASCVD cases during a mean of 4.89 years of follow-up. Multivariable adjusted analysis revealed that compared with no exposure, cumNon-HDL-C duration 2, 4 and 6 years increased ASCVD risk by 26% (HR: 1.26, 95% CI: 1.07–1.47), 56% (HR: 1.56, 95% CI: 1.31–1.86) and 91% (HR: 1.91, 95% CI: 1.59–2.31) respectively; The hazard ratios (HRs) for the fourth and fifth versus lowest quintile of cumNon-HDL-C concentration were 1.25 and 1.72 for ASCVD. Each standard deviation increment in cumNon-HDL-C concentration was associated with a 10% increased risk of ASCVD.ConclusionLong-term and higher cumNon-HDL-C were all significantly associated with an increased risk of ASCVD independent of single non-HDL-C level.

Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Racially Diverse Populations

“…Non‐HDL‐C has also been recommended by American College of Cardiology/American Heart Association 6 and European Society of Cardiology/European Atherosclerosis Society guidelines 2 for CVD risk assessment, given its association with incident CVD in different populations, including those from Europe, Australia, North America, 58 and China. 59 , 60 Finally, 3 lipid components within IDL, IDL‐C, IDL‐FC, and IDL‐phospholipids, showed positive associations with incident CHD in this study and MESA, 25 whereas UK Biobank reported inverse associations for IDL‐FC and IDL‐phospholipids. 24 Therefore, more studies are needed to clarify the role of IDL lipid components in predicting CHD risk.…”

The new Systematic Coronary Risk Evaluation (SCORE2 and SCORE2-OP) estimates the risk of arterial occlusive events in chronic myeloid leukemia patients treated with nilotinib or ponatinib

“…Non-HDL-C is an estimate of the total amount of pro-atherogenic apolipoprotein B (ApoB)–containing lipoproteins, including very low– and low-density lipoproteins (LDL) [ 26 ]. Numerous studies have shown that non-HDL-C is significantly associated with an elevated risk of atherosclerotic cardiovascular disease [ 27 ].…”