Evaluation of non-HDL cholesterol as a predictor of non-fatal cardiovascular events in a prospective population cohort

Clin Investig Arterioscler. 2018 Mar-Apr;30(2):64-71. doi: 10.1016/j.arteri.2017.10.003. Epub 2018 Feb 1.
[Article in English, Spanish]

Abstract

Introduction: Non-HDL cholesterol (non-HDL-C) is becoming relevant both in its participation in cardiovascular risk assessment and as a therapeutic target. The objective of the present study was to assess the independent predictive capacity of both non-HDL-C and LDL-C (the main priority in dyslipidemias to reduce cardiovascular risk), in cardiovascular morbidity in a population-based sample.

Methods: A prospective cohort study involving 1186 individuals in the non-HDL-C group and 1177 in the LDL-C group, followed for 10.7years (SD=2.2), who had not had any previous cardiovascular event. The predictor variables included in the adjustment were: gender, age, arterial hypertension, diabetes mellitus, smoker status and non-HDL-C in one group. In the other group, consisting of patients presenting TG levels of 400mg/dL, non-HDL-C was replaced by LDL-C. Survival curves (Kaplan-Meier) were calculated and two Cox regression models were applied, one for each group.

Results: Non-HDL-C group presented 6.2% of non-fatal cardiovascular episodes during follow-up and the LDL-C group 6.0%. After adjustment, for each 30mg/dL increase in non-HDL-C, the incidence of new non-fatal cardiovascular events increased by 31% (HR=1.31, 95%CI: 1.06-1.61; P=.018) and in the LDL-C group by 27% (HR=1.27, 95%CI: 0.97-1.61, P=.068).

Conclusions: After a follow-up of 10.7years, non-HDL-C has been shown in our population as a prognostic factor of non-fatal cardiovascular disease, but not LDL-C, although its HR is close to statistical significance.

Keywords: Aterosclerosis; Atherosclerosis; Cardiovascular diseases; Cohort studies; Enfermedad cardiovascular; Estudio de cohortes; Factores de riesgo; Morbidity; Morbilidad; Risk factors.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / epidemiology*
  • Cholesterol / blood*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood*
  • Cohort Studies
  • Dyslipidemias / blood
  • Dyslipidemias / complications*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Triglycerides / blood

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides
  • Cholesterol