Abstract
Abstract P339: 30-Year Absolute Risks for Coronary Heart Disease in Individuals With Very Low LDL-C
Circulation (New York, N.Y.), Vol.139(Suppl_1)
03/05/2019
DOI: 10.1161/circ.139.suppl_1.P339
Abstract
Introduction:
It is unclear if individuals with very low mean low-density lipoprotein cholesterol (LDL-C) during midlife experience significant absolute risk (AR) for coronary heart disease (CHD).
Hypothesis:
Individuals with LDL-C ≤80mg/dL from ages 20-60 years (y) do not develop significant AR for CHD over 30 y of follow-up.
Methods:
Our objective was to quantify and compare the 30-year AR for fatal or nonfatal CHD from index ages 20-40 y and 40-60 y in participants (ppts) with LDL-C ≤80, 81-130, and >130 mg/dL using data from the Lifetime Risk Pooling Project. We included ppts who were free from lipid lowering medications and CHD at baseline. Mean LDL-C was an average of multiple (2-5) fasting LDL-C measurements within 10 years prior to the baseline age. We used a modified Kaplan Meier analysis, adjusted for competing risks of death, to quantify the 30-year CHD AR by LDL-C strata.
Results:
3,781 men and 4,995 women were followed for a combined 110,431 person*years and experienced 778 events. Among all ppts, tobacco use ranged from 20-40% and hypertension prevalence ranged from 13-40%. Non-lipid risk factor profiles were generally more favorable in the low-LDL-C strata. At index ages 20-40, men and women with LDL-C ≤80mg/dL did not experience risk for CHD over 20 and 25 years, respectively (Figure). A similar pattern was seen in the LDL-C 80-130mg/dL strata. At index ages 40-60, men and women with LDL-C ≤80mg/dL experienced no risk for CHD for 5 to 15 years, respectively. However, both sex groups saw a gradual increase in risk up to 13.7% (95% confidence interval [CI] 1.9-25.4%) for men and 5.2% (95% CI 2.0-8.4%) for women at year 30 of follow-up.
Conclusion:
Young ppts with LDL-C ≤80mg/dL had very low CHD risks across midlife despite significant risk factor burden. At older ages, ppts with low LDL-C develop modest AR for CHD suggesting adverse lipid changes over time or alternative mediators of CHD in this age group.
Details
- Title: Subtitle
- Abstract P339: 30-Year Absolute Risks for Coronary Heart Disease in Individuals With Very Low LDL-C
- Creators
- William Schultz - Northwestern Memorial HospitalHongyan Ning - Northwestern Memorial HospitalAmanda Marma-Perak - Northwestern Memorial HospitalMatthew Feinstein - Northwestern Memorial HospitalAllan Sniderman - McGill UniversityJennifer Robinson - University of IowaJarett Berry - The University of Texas Southwestern Medical CenterDonald M Lloyd-Jones - Northwestern Memorial HospitalJohn T Wilkins - Northwestern Memorial Hosp, Chicago, IL
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.139(Suppl_1)
- DOI
- 10.1161/circ.139.suppl_1.P339
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 03/05/2019
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984364533402771
Metrics
7 Record Views