High visit-to-visit cholesterol variability predicts heart failure and adverse cardiovascular events: a population-based cohort study

Chan, Jeffrey Shi Kai; Satti, Danish Iltaf; Lee, Yan Hiu Athena; Hui, Jeremy Man Ho; Lee, Teddy Tai Loy; Chou, Oscar Hou In; Wai, Abraham Ka Chung; Ciobanu, Ana; Liu, Ying; Liu, Tong; Roever, Leonardo; Biondi‐Zoccai, Giuseppe; Zhang, Qingpeng; Cheung, Bernard Man Yung; Zhou, Jiandong; Tse, Gary

doi:10.1093/eurjpc/zwac097

Cited by 23 publications

(24 citation statements)

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“…Diagnoses were recorded by International Classification of Diseases, Ninth revision (ICD‐9) codes (Table ) regardless of the year of entry, as ICD‐10 codes have not been implemented to date. CDARS has been used in previous studies and shown to have good coding accuracy 4–6 …”

Section: Methodsmentioning

confidence: 99%

“…CDARS has been used in previous studies and shown to have good coding accuracy. [4][5][6] Patients aged ≥18 years old with PCa who received any GnRH agonist (leuprorelin, triptorelin, or goserelin) during December 1999 and March 2021 were included. Patients who switched to GnRH antagonists, underwent bilateral orchidectomy, had <6 months of GnRH agonist, prior myocardial infarction (MI), or prior stroke were excluded.…”

Section: Introductionmentioning

confidence: 99%

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Association between duration of gonadotrophin‐releasing hormone agonist use and cardiovascular risks: A population‐based competing‐risk analysis

Chan¹,

Tang²,

Hui³

et al. 2022

The Prostate

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Background: Although androgen deprivation therapy has known cardiovascular risks, it is unclear if its duration is related to cardiovascular risks. This study thus aimed to investigate the associations between gonadotrophin-releasing hormone (GnRH) agonist use duration and cardiovascular risks.Methods: This retrospective cohort study included adult patients with prostate cancer receiving GnRH agonists in Hong Kong during 1999-2021. Patients who switched to GnRH antagonists, underwent bilateral orchidectomy, had <6 months of GnRH agonist, prior myocardial infarction (MI), or prior stroke was excluded. All patients were followed up until September 2021 for a composite endpoint of MI and stroke. Multivariable competing-risk regression using the Fine-Gray subdistribution model was used, with mortality from any cause as the competing event.Results: In total, 4038 patients were analyzed (median age 74.9 years old, interquartile range (IQR) 68.7-80.8 years old). Over a median follow-up of 4.1 years (IQR 2.1-7.5 years), longer GnRH agonists use was associated with higher risk of the endpoint (sub-hazard ratio per year 1.04 [1.01-1.06], p = 0.001), with those

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between duration of gonadotrophin‐releasing hormone agonist use and cardiovascular risks: A population‐based competing‐risk analysis

Chan¹,

Tang²,

Hui³

et al. 2022

The Prostate

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“…The ICD-9 codes used for identifying comorbid conditions and the outcome (HF) were summarized in Table S1 . CDARS has been extensively used in prior studies and has been shown to have good diagnostic coding accuracy 19, 20 . As only retrospective, deidentified data were used, the requirement for individual patient consent has been waived.…”

Section: Methodsmentioning

confidence: 99%

“…The copyright holder for this preprint this version posted June 29, 2022. ; https://doi.org /10.1101/2022.06.28.22277033 doi: medRxiv preprint coding accuracy 19,20 . As only retrospective, deidentified data were used, the requirement for individual patient consent has been waived.…”

Section: Study Design and Populationmentioning

confidence: 99%

Triglyceride-glucose index and the risk of heart failure: evidence from two large cohorts and a Mendelian randomization analysis

Chan²,

Guan

et al. 2022

Preprint

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Background: The relationship between triglyceride-glucose (TyG) index, an emerging marker of insulin resistance, and the risk of incident heart failure (HF) was unclear. This study thus aimed to investigate this relationship. Methods: Subjects without prevalent cardiovascular diseases from the prospective Kailuan cohort (recruited during 2006-2007) and a retrospective cohort of family medicine patients from Hong Kong (recruited during 2000-2003) were followed up until December 31st, 2019 for the outcome of incident HF. Separate adjusted hazard ratios (aHRs) summarizing the relationship between TyG index and HF risk in the two cohorts were combined using a random-effect meta-analysis. Additionally, a two-sample Mendelian randomization (MR) of published genome-wide association study data was performed to assess the causality of observed associations. Results: In total, 95,996 and 19,345 subjects from the Kailuan and Hong Kong cohorts were analyzed, respectively, with 2,726 cases (2.8%) of incident HF in the former and 1,709 (7.0%) in the latter. Subjects in the highest quartile of TyG index had the highest risk of incident HF in both cohorts (Kailuan: aHR 1.23 (95% confidence interval: 1.09-1.39), PTrend <0.001; Hong Kong: aHR 1.21 (1.04-1.40), PTrend =0.007; both compared with the lowest quartile). Meta-analysis showed similar results (highest versus lowest quartile: HR 1.22(1.11-1.34), P<0.0001). Findings from MR analysis, which included 47,309 cases and 930,014 controls, supported a causal relationship between higher TyG index and increased risk of HF (odds ratio 1.27(1.15-1.40), P<0.001). Conclusion: A higher TyG index is an independent and causal risk factor for incident HF in the general population.

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“…There has been increased interest in VVLV over recent years, particularly its role as a surrogate marker for vascular disease (10). Recent epidemiological research has demonstrated that such variability is associated with numerous adverse clinical events, such as heart failure (11), myocardial infarction (12,13), stroke (13), sudden cardiac death (14), and mortality (11,15). However, its association with incident cancer has been relatively unexplored, despite the aforementioned links between lipid metabolism and incident cancer.…”

Section: Introductionmentioning

confidence: 99%

Association between visit-to-visit lipid variability and incident cancer: a population-based cohort study

Chan¹,

Satti²,

Lee³

et al. 2022

Preprint

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Background: Dyslipidaemia is associated with increased cancer risk. However, the prognostic value of visit-to-visit lipid variability (VVLV) is unexplored in this regard. Objective: To investigate the associations between VVLV and the risk of incident cancer. Design: Retrospective cohort study. Setting: Family medicine clinics. Patients: Adults attending a family medicine clinic in Hong Kong during 2000-2003, excluding those with <3 tests for low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and total cholesterol (TC) each, those with prior cancer diagnosis, and those with <1 year of follow-up. Measurements: Visit-to-visit LDL-C, HDL-C, TC, and triglycerides variabilities were measured by the coefficient of variation (CV). Patients were followed up until 31st December 2019 for the primary outcome of incident cancer. Results: Altogether, 69,186 patients were included (26,679 males (38.6%); mean age 60+/-13 years; mean follow-up 16+/-3 years); 7958 patients (11.5%) had incident cancer. Higher variability of LDL-C, HDL-C, TC, and TG was associated with higher risk of incident cancer. Patients in the third tercile of the CV of LDL-C (adjusted hazard ratio (aHR) against first tercile 1.06 [1.00, 1.12], p=0.049), HDL-C (aHR 1.37 [1.29, 1.44], p<0.001), TC (aHR 1.10 [1.04, 1.17], p=0.001), and TG (aHR 1.11 [1.06, 1.18], p<0.001) had the highest risks of incident cancer. Among these, only HDL-C variability remained associated with the risk of incident cancer in users of statins/fibrates. Limitations: Due to the observational nature of this study, there may be residual and unmeasured confounders. Patient data could not be individually adjudicated, implying that coding errors may be possible.

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High visit-to-visit cholesterol variability predicts heart failure and adverse cardiovascular events: a population-based cohort study

Cited by 23 publications

References 10 publications

Association between duration of gonadotrophin‐releasing hormone agonist use and cardiovascular risks: A population‐based competing‐risk analysis

Association between duration of gonadotrophin‐releasing hormone agonist use and cardiovascular risks: A population‐based competing‐risk analysis

Triglyceride-glucose index and the risk of heart failure: evidence from two large cohorts and a Mendelian randomization analysis

Association between visit-to-visit lipid variability and incident cancer: a population-based cohort study

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