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The independent correlation between high-density lipoprotein cholesterol and subsequent major adverse coronary events.
Am Heart J. 2006 Mar; 151(3):755.e1-755.e6.AH

Abstract

BACKGROUND

There is substantial evidence from clinical trials that lowering low-density lipoprotein cholesterol (LDL-C) reduces cardiovascular risk. There is less evidence for the salutatory effects of raising high-density lipoprotein cholesterol (HDL-C). The predictive strength of an initial HDL-C measurement and its change over time for major adverse coronary events is not well understood.

METHODS

We identified a cohort of all 6928 patients in an urban primary care practice who had two or more lipid measurements between January 1985 and December 1997. We used bivariable and multivariable (Cox proportional hazards) techniques to identify independent predictors of subsequent major adverse coronary events (hospitalization for myocardial infarction or acute coronary syndrome) after the second set of lipid measurements.

RESULTS

The time between first and second lipid measurements averaged 2.6 years. During a mean of 5.1 +/- 3.2 years of observation after their second lipid measurements, 2167 (31%) patients had an acute coronary event. Patients having events were significantly older, more often white, male, and smokers and more often had antecedent diabetes, hypertension, coronary heart disease, and myocardial infarctions. Adjusting for covariates, a 10-mg/dL higher initial HDL-C was associated with an 11% (95% CI 7%-14%) lower risk of coronary events. A 10-mg/dL increase in HDL-C between lipid measurements was associated with a 7% (95% CI 3%-10%) lower risk of events. Neither initial or change in triglycerides nor LDL-C predicted subsequent coronary events.

CONCLUSION

High-density lipoprotein cholesterol measurements and change in HDL-C predicted major adverse coronary events in this urban practice, which provides support studying interventions targeting HDL-C for cardiovascular risk reduction.

Authors+Show Affiliations

GlaxoSmithKline, Inc., Collegeville, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16504648

Citation

Koro, Carol E., et al. "The Independent Correlation Between High-density Lipoprotein Cholesterol and Subsequent Major Adverse Coronary Events." American Heart Journal, vol. 151, no. 3, 2006, pp. 755.e1-755.e6.
Koro CE, Bowlin SJ, Stump TE, et al. The independent correlation between high-density lipoprotein cholesterol and subsequent major adverse coronary events. Am Heart J. 2006;151(3):755.e1-755.e6.
Koro, C. E., Bowlin, S. J., Stump, T. E., Sprecher, D. L., & Tierney, W. M. (2006). The independent correlation between high-density lipoprotein cholesterol and subsequent major adverse coronary events. American Heart Journal, 151(3), e1-e6.
Koro CE, et al. The Independent Correlation Between High-density Lipoprotein Cholesterol and Subsequent Major Adverse Coronary Events. Am Heart J. 2006;151(3):755.e1-755.e6. PubMed PMID: 16504648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The independent correlation between high-density lipoprotein cholesterol and subsequent major adverse coronary events. AU - Koro,Carol E, AU - Bowlin,Steven J, AU - Stump,Timothy E, AU - Sprecher,Dennis L, AU - Tierney,William M, PY - 2005/09/05/received PY - 2005/12/06/accepted PY - 2006/3/1/pubmed PY - 2006/3/22/medline PY - 2006/3/1/entrez SP - 755.e1 EP - 755.e6 JF - American heart journal JO - Am Heart J VL - 151 IS - 3 N2 - BACKGROUND: There is substantial evidence from clinical trials that lowering low-density lipoprotein cholesterol (LDL-C) reduces cardiovascular risk. There is less evidence for the salutatory effects of raising high-density lipoprotein cholesterol (HDL-C). The predictive strength of an initial HDL-C measurement and its change over time for major adverse coronary events is not well understood. METHODS: We identified a cohort of all 6928 patients in an urban primary care practice who had two or more lipid measurements between January 1985 and December 1997. We used bivariable and multivariable (Cox proportional hazards) techniques to identify independent predictors of subsequent major adverse coronary events (hospitalization for myocardial infarction or acute coronary syndrome) after the second set of lipid measurements. RESULTS: The time between first and second lipid measurements averaged 2.6 years. During a mean of 5.1 +/- 3.2 years of observation after their second lipid measurements, 2167 (31%) patients had an acute coronary event. Patients having events were significantly older, more often white, male, and smokers and more often had antecedent diabetes, hypertension, coronary heart disease, and myocardial infarctions. Adjusting for covariates, a 10-mg/dL higher initial HDL-C was associated with an 11% (95% CI 7%-14%) lower risk of coronary events. A 10-mg/dL increase in HDL-C between lipid measurements was associated with a 7% (95% CI 3%-10%) lower risk of events. Neither initial or change in triglycerides nor LDL-C predicted subsequent coronary events. CONCLUSION: High-density lipoprotein cholesterol measurements and change in HDL-C predicted major adverse coronary events in this urban practice, which provides support studying interventions targeting HDL-C for cardiovascular risk reduction. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16504648/The_independent_correlation_between_high_density_lipoprotein_cholesterol_and_subsequent_major_adverse_coronary_events_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(05)01067-7 DB - PRIME DP - Unbound Medicine ER -