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- Title
CALCULATED SMALL DENSE LDL-C PREDICTS ATHEROSCLEROTIC CARDIOVASCULAR EVENTS BETTER THAN OTHER COMPONENTS OF THE LIPID PANEL.
- Authors
Rafael, Zubiran Sanabria; Maureen, Sampson
- Abstract
Introducción: Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of death worldwide. Therefore, cardiovascular risk assessment is fundamental in preventive cardiology, beginning with global risk assessment and subsequently considering various factors, including biomarkers, demographics, and subclinical atherosclerosis screening, to enhance risk estimation and guide preventive therapy decisions. Objetivo: The objective of the study was to assess and compare the predictive power of various lipid markers, including sdLDLc, in estimating the risk of all-cause ASCVD and associated mortality using data from the UK Biobank. Material y Métodos: We compared the formulas for small dense LDLc (sdLDLc), Sampson (SLDLc), enhanced Sampson (eSLDLc), extended Martin (MLDLc), Non-HDLc and measured Apolipoprotein B across various percentiles. Our goal was to predict all-cause ASCVD and associated mortality. We analyzed a large sample from the UK Biobank (n = 267,451), excluding any individuals with missing data of their lipid panel, those on lipid lowering treatment, and those with incomplete follow-up records. We performed survival time analysis where statistical differences between predefined groups were tested using Log-Rank test. Cox proportional hazard regression was performed with all models adjusted for age, sex, race, diabetes, systolic blood pressure, smoking and hypertension medication. Resultados: Among the analyzed parameters, several were found to be significant predictors of cardiovascular disease risk. Significantly, Non-HDLc demonstrated a robust association, exhibiting a hazard ratio (HR) of 1.18 (95% CI: 1.16-1.19, p <0.001). ApoB similarly displayed a strong association with cardiovascular risk, with an HR 1.18 (95% CI: 1.17-1.20,p <0.001). While both performed better than any other LDL-C formula, unexpectedly sdLDLc exhibited an even higher HR of 1.19 (95% CI: 1.18-1.20, p<0.0001). Our univariate survival-curve analysis, estimated sdLDLc was superior to other risk-enhancer tests in predicting ASCVD events. After multivariate adjustment for other known ASCVD risk factors, estimated sdLDLc still had the strongest association with ASCVD compared to other lipid parameters. Conclusiones: sdLDLc was superior to any other formula, non-HDLc or ApoB to predict a ASCVD event or associated death. Since it relies solely on the typical components of a lipid panel, estimating sdLDLc for all individuals is feasible, and it has the potential to significantly improve ASCVD risk stratification.
- Subjects
MEXICO; ATHEROSCLEROSIS risk factors; CARDIOVASCULAR disease related mortality; CARDIOVASCULAR diseases risk factors; UK Biobank Ltd.; LDL cholesterol; CONFERENCES &; conventions; ATHEROSCLEROSIS; RISK assessment
- Publication
Revista Mexicana de Endocrinología, Metabolismo y Nutrición, 2023, Vol 10, p24
- ISSN
2339-9643
- Publication type
Article