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High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study

Aim: A high-risk strategy has been implemented for lipid-lowering therapy in the primary prevention of cardiovascular disease. However, atherosclerosis and cardiovascular events are common among individuals with low cardiovascular risk. This study aimed to determine whether the small dense low-densi...

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Autores principales: Qi, Yue, Liu, Jing, Wang, Wei, Wang, Miao, Zhao, Fan, Sun, Jiayi, Liu, Jun, Deng, Qiuju, Zhao, Dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japan Atherosclerosis Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406409/
https://www.ncbi.nlm.nih.gov/pubmed/31666437
http://dx.doi.org/10.5551/jat.49841
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author Qi, Yue
Liu, Jing
Wang, Wei
Wang, Miao
Zhao, Fan
Sun, Jiayi
Liu, Jun
Deng, Qiuju
Zhao, Dong
author_facet Qi, Yue
Liu, Jing
Wang, Wei
Wang, Miao
Zhao, Fan
Sun, Jiayi
Liu, Jun
Deng, Qiuju
Zhao, Dong
author_sort Qi, Yue
collection PubMed
description Aim: A high-risk strategy has been implemented for lipid-lowering therapy in the primary prevention of cardiovascular disease. However, atherosclerosis and cardiovascular events are common among individuals with low cardiovascular risk. This study aimed to determine whether the small dense low-density lipoprotein cholesterol (sdLDLC) level can predict carotid atherosclerosis progression and identify high-risk individuals. Methods: Baseline sdLDLC and low-density lipoprotein cholesterol (LDLC) were measured in 808 particip ants from the Chinese Multi-provincial Cohort Study, aged 45–74 years. Adjusted relative risk was calculated using a modified Poisson regression model to assess the relationship between sdLDLC and 5-year atherosclerosis progression, as indicated by the progression, incidence, and multi-territorial extent of carotid plaque. Results: The 5-year atherosclerosis progression increased significantly with increased sdLDLC. Baseline sdLDLC was significantly associated with the short-term risk of plaque progression after multivariable adjustment, even in participants with low LDLC or a 10-year estimated cardiovascular risk. sdLDLC predicted plaque progression (relative risk 2.05; 95% confidence interval 1.43–2.93) in participants with LDLC < 130 mg/dL. Furthermore, participants with the highest sdLDLC but intermediate or low cardiovascular risk (accounting for 16% of the cohort) had double the risk of plaque progression, which was comparable to those with the same sdLDLC and high cardiovascular risk, relative to those with the lowest sdLDLC levels and low cardiovascular risk. Conclusions: sdLDLC is independently associated with the progression of carotid atherosclerosis, which may provide a basis for clinicians to reclassify individuals believed to be at low cardiovascular risk into the high-risk category, and those with high sdLDLC may benefit from more aggressive cholesterol-lowering treatment.
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spelling pubmed-74064092020-08-19 High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study Qi, Yue Liu, Jing Wang, Wei Wang, Miao Zhao, Fan Sun, Jiayi Liu, Jun Deng, Qiuju Zhao, Dong J Atheroscler Thromb Original Article Aim: A high-risk strategy has been implemented for lipid-lowering therapy in the primary prevention of cardiovascular disease. However, atherosclerosis and cardiovascular events are common among individuals with low cardiovascular risk. This study aimed to determine whether the small dense low-density lipoprotein cholesterol (sdLDLC) level can predict carotid atherosclerosis progression and identify high-risk individuals. Methods: Baseline sdLDLC and low-density lipoprotein cholesterol (LDLC) were measured in 808 particip ants from the Chinese Multi-provincial Cohort Study, aged 45–74 years. Adjusted relative risk was calculated using a modified Poisson regression model to assess the relationship between sdLDLC and 5-year atherosclerosis progression, as indicated by the progression, incidence, and multi-territorial extent of carotid plaque. Results: The 5-year atherosclerosis progression increased significantly with increased sdLDLC. Baseline sdLDLC was significantly associated with the short-term risk of plaque progression after multivariable adjustment, even in participants with low LDLC or a 10-year estimated cardiovascular risk. sdLDLC predicted plaque progression (relative risk 2.05; 95% confidence interval 1.43–2.93) in participants with LDLC < 130 mg/dL. Furthermore, participants with the highest sdLDLC but intermediate or low cardiovascular risk (accounting for 16% of the cohort) had double the risk of plaque progression, which was comparable to those with the same sdLDLC and high cardiovascular risk, relative to those with the lowest sdLDLC levels and low cardiovascular risk. Conclusions: sdLDLC is independently associated with the progression of carotid atherosclerosis, which may provide a basis for clinicians to reclassify individuals believed to be at low cardiovascular risk into the high-risk category, and those with high sdLDLC may benefit from more aggressive cholesterol-lowering treatment. Japan Atherosclerosis Society 2020-07-01 /pmc/articles/PMC7406409/ /pubmed/31666437 http://dx.doi.org/10.5551/jat.49841 Text en 2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.http://creativecommons.org/licenses/by-nc-sa/3.0/
spellingShingle Original Article
Qi, Yue
Liu, Jing
Wang, Wei
Wang, Miao
Zhao, Fan
Sun, Jiayi
Liu, Jun
Deng, Qiuju
Zhao, Dong
High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study
title High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study
title_full High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study
title_fullStr High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study
title_full_unstemmed High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study
title_short High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study
title_sort high sdldl cholesterol can be used to reclassify individuals with low cardiovascular risk for early intervention: findings from the chinese multi-provincial cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406409/
https://www.ncbi.nlm.nih.gov/pubmed/31666437
http://dx.doi.org/10.5551/jat.49841
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