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The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry

BACKGROUND: Despite the importance of attaining optimal lipid levels from a young age to secure long-term cardiovascular health, the detailed impact of non-optimal lipid levels in young adults on coronary artery calcification (CAC) is not fully explored. We sought to investigate the risk of CAC prog...

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Autores principales: Lee, Heesun, Ahn, Hyo-Jeong, Park, Hyo Eun, Han, Donghee, Chang, Hyuk-Jae, Chun, Eun Ju, Han, Hae-Won, Sung, Jidong, Jung, Hae Ok, Choi, Su-Yeon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10392939/
https://www.ncbi.nlm.nih.gov/pubmed/37534276
http://dx.doi.org/10.3389/fcvm.2023.1173289
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author Lee, Heesun
Ahn, Hyo-Jeong
Park, Hyo Eun
Han, Donghee
Chang, Hyuk-Jae
Chun, Eun Ju
Han, Hae-Won
Sung, Jidong
Jung, Hae Ok
Choi, Su-Yeon
author_facet Lee, Heesun
Ahn, Hyo-Jeong
Park, Hyo Eun
Han, Donghee
Chang, Hyuk-Jae
Chun, Eun Ju
Han, Hae-Won
Sung, Jidong
Jung, Hae Ok
Choi, Su-Yeon
author_sort Lee, Heesun
collection PubMed
description BACKGROUND: Despite the importance of attaining optimal lipid levels from a young age to secure long-term cardiovascular health, the detailed impact of non-optimal lipid levels in young adults on coronary artery calcification (CAC) is not fully explored. We sought to investigate the risk of CAC progression as per lipid profiles and to demonstrate lipid optimality in young adults. METHODS: From the KOrea Initiative on Coronary Artery calcification (KOICA) registry that was established in six large volume healthcare centers in Korea, 2,940 statin-naïve participants aged 20–45 years who underwent serial coronary calcium scans for routine health check-ups between 2002 and 2017 were included. The study outcome was CAC progression, which was assessed by the square root method. The risk of CAC progression was analyzed according to the lipid optimality and each lipid parameter. RESULTS: In this retrospective cohort (mean age, 41.3 years; men 82.4%), 477 participants (16.2%) had an optimal lipid profile, defined as triglycerides <150 mg/dl, LDL cholesterol <100 mg/dl, and HDL cholesterol >60 mg/dl. During follow-up (median, 39.7 months), CAC progression was observed in 434 participants (14.8%), and more frequent in the non-optimal lipid group (16.5% vs. 5.7%; p < 0.001). Non-optimal lipids independently increased the risk of CAC progression [adjusted hazard ratio (aHR), 1.97; p = 0.025], in a dose-dependent manner. Even in relatively low-risk participants with an initial calcium score of zero (aHR, 2.13; p = 0.014), in their 20 s or 30 s (aHR 2.15; p = 0.041), and without other risk factors (aHR 1.45; p = 0.038), similar results were demonstrable. High triglycerides had the greatest impact on CAC progression in this young adult population. CONCLUSION: Non-optimal lipid levels were significantly associated with the risk of CAC progression in young adults, even at low-risk. Screening and intervention for non-optimal lipid levels, particularly triglycerides, from an early age might be of clinical value.
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spelling pubmed-103929392023-08-02 The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry Lee, Heesun Ahn, Hyo-Jeong Park, Hyo Eun Han, Donghee Chang, Hyuk-Jae Chun, Eun Ju Han, Hae-Won Sung, Jidong Jung, Hae Ok Choi, Su-Yeon Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Despite the importance of attaining optimal lipid levels from a young age to secure long-term cardiovascular health, the detailed impact of non-optimal lipid levels in young adults on coronary artery calcification (CAC) is not fully explored. We sought to investigate the risk of CAC progression as per lipid profiles and to demonstrate lipid optimality in young adults. METHODS: From the KOrea Initiative on Coronary Artery calcification (KOICA) registry that was established in six large volume healthcare centers in Korea, 2,940 statin-naïve participants aged 20–45 years who underwent serial coronary calcium scans for routine health check-ups between 2002 and 2017 were included. The study outcome was CAC progression, which was assessed by the square root method. The risk of CAC progression was analyzed according to the lipid optimality and each lipid parameter. RESULTS: In this retrospective cohort (mean age, 41.3 years; men 82.4%), 477 participants (16.2%) had an optimal lipid profile, defined as triglycerides <150 mg/dl, LDL cholesterol <100 mg/dl, and HDL cholesterol >60 mg/dl. During follow-up (median, 39.7 months), CAC progression was observed in 434 participants (14.8%), and more frequent in the non-optimal lipid group (16.5% vs. 5.7%; p < 0.001). Non-optimal lipids independently increased the risk of CAC progression [adjusted hazard ratio (aHR), 1.97; p = 0.025], in a dose-dependent manner. Even in relatively low-risk participants with an initial calcium score of zero (aHR, 2.13; p = 0.014), in their 20 s or 30 s (aHR 2.15; p = 0.041), and without other risk factors (aHR 1.45; p = 0.038), similar results were demonstrable. High triglycerides had the greatest impact on CAC progression in this young adult population. CONCLUSION: Non-optimal lipid levels were significantly associated with the risk of CAC progression in young adults, even at low-risk. Screening and intervention for non-optimal lipid levels, particularly triglycerides, from an early age might be of clinical value. Frontiers Media S.A. 2023-07-17 /pmc/articles/PMC10392939/ /pubmed/37534276 http://dx.doi.org/10.3389/fcvm.2023.1173289 Text en © 2023 Lee, Ahn, Park, Han, Chang, Chun, Han, Sung, Jung and Choi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Lee, Heesun
Ahn, Hyo-Jeong
Park, Hyo Eun
Han, Donghee
Chang, Hyuk-Jae
Chun, Eun Ju
Han, Hae-Won
Sung, Jidong
Jung, Hae Ok
Choi, Su-Yeon
The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry
title The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry
title_full The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry
title_fullStr The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry
title_full_unstemmed The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry
title_short The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry
title_sort effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from koica registry
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10392939/
https://www.ncbi.nlm.nih.gov/pubmed/37534276
http://dx.doi.org/10.3389/fcvm.2023.1173289
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