Non-HDL cholesterol predicts long-term cardiac risk in CHD patients
MedWire News: Baseline levels of non-high-density lipoprotein (non-HDL) cholesterol may be useful for predicting long-term cardiac death in patients with coronary heart disease (CHD) after coronary artery bypass graft (CABG) surgery, say Japanese researchers.
Non-HDL cholesterol has previously been shown to predict the short-term risk for cardiovascular (CV) events in individuals with CHD, explain Hirotoshi Ohmura (Juntendo University School of Medicine, Tokyo) and team. However, few studies have investigated the predictive value of non-HDL cholesterol for long-term prognosis in these patients.
To address this, 1074 consecutive CHD patients who underwent CABG between 1984 and 1995 were recruited, and mortality data were ascertained through 2000.
As reported in Atherosclerosis, 90 cardiac deaths and 297 all-cause deaths occurred over a mean follow-up period of 10.6 years.
Cumulative survival curves revealed that individuals with high non-HDL cholesterol levels (≥180 mg/dL [4.66 mmol/L]) had a significantly lower cardiac death survival rate than those with lower levels. However, no significant difference was observed for all-cause mortality rates between the two groups.
Of note, when the researchers divided the patients into two groups by the mean low-density lipoprotein (LDL) cholesterol level (146 mg/dL [3.78 mmol/L]) they found no significant difference in cumulative rates of cardiac or all-cause mortality between groups.
In proportional regression analysis, adjusted for conventional coronary risk factors, the metabolic syndrome, statin treatment, and use of an artery bypass graft, each 10 mg/dL (0.26 mmol/L) increase in non-HDL cholesterol was associated with a 22% increased risk for cardiac death.
These findings suggest that non-HDL cholesterol may be a "practical and distinct predictor of cardiovascular outcomes and a target for lipid-lowering therapy for both primary and secondary prevention," conclude Ohmura et al.
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By Nikki Withers