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Association between HDL-C concentration and risk for a major cardiovascular event
David L Laitinen1, Shivaji Manthena, Silky Webb
1Global Health Economics & Outcomes Research, Abbott Laboratories, Abbott Park, IL 60064-6145, USA. dave.laitinen@abbott.com
Insights
Higher high-density lipoprotein cholesterol (HDL-C) levels are linked to a reduced risk of major cardiovascular events. Maintaining optimal HDL-C may be crucial for preventing heart disease and stroke.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Cardiovascular disease remains a leading cause of mortality worldwide.
- High-density lipoprotein cholesterol (HDL-C) is recognized as a key factor in cardiovascular risk assessment.
- Understanding the precise relationship between HDL-C levels and cardiovascular event risk is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate the association between baseline high-density lipoprotein cholesterol (HDL-C) concentrations and the risk of major cardiovascular events.
- To quantify the impact of HDL-C levels on cardiovascular event occurrence within a 5-year timeframe.
- To identify specific HDL-C thresholds associated with increased cardiovascular risk in different demographic groups.
Main Methods:
- A retrospective longitudinal analysis was performed using a large US claims database.
- Patients aged 50 years and older with complete lipid panel results and continuous enrollment were included.
- Cox proportional hazards analysis was employed to assess the association between HDL-C and cardiovascular events, adjusting for covariates.
Main Results:
- A statistically significant inverse association was found between HDL-C concentrations and the risk of major cardiovascular events.
- Each 0.026 mmol/L (1 mg/dL) increase in HDL-C was associated with a 1.3% decrease in cardiovascular event risk.
- This protective association of HDL-C became apparent within one year of follow-up.
Conclusions:
- Baseline HDL-C concentrations are inversely associated with the occurrence of cardiovascular events within five years.
- Women and men with HDL-C levels significantly below target demonstrated elevated cardiovascular risk, comparable to individuals with pre-existing cardiovascular conditions.
- Findings highlight the importance of monitoring and managing HDL-C levels for cardiovascular risk reduction, acknowledging limitations of claims data analysis.
Objective:
To determine the association between baseline HDL-C concentrations and risk of a major cardiovascular event (within 5 years) in a large US claims database.
Methods:
A retrospective longitudinal analysis using claims data from the i3 Ingenix LabRx database was conducted. Patients were included if they had complete lipid panel lab results, were continuously enrolled for >or=6 months prior to and >or=12 months following the lab test (index date), and were >or=50 years of age. Cox proportional hazards analysis assessed the association between HDL-C concentrations and risk of a major cardiovascular event within 5 years of the index date, after adjusting for covariates.
Results:
There was a statistically significant association between HDL-C and risk of a major cardiovascular event. A 0.026 mmol/L (1 mg/dL) increase in HDL-C from baseline was associated with a 1.3% decreased risk of a major cardiovascular event (e.g., a 0.13 mmol/L [5 mg/dL] increase in HDL-C above baseline concentrations was associated with a 6.5% decrease). This association became evident within 1 year of follow-up.
Conclusions:
HDL-C concentrations were inversely associated with the occurrence of cardiovascular events within 5 years. Women who were >or=0.26 mmol/L (10 mg/dL) below their target concentrations had cardiovascular risk similar to that of women with baseline ischemic heart disease and hypertension, and men who were >or=0.26 mmol/L (10 mg/dL) below their target concentrations had cardiovascular risk similar to that of men with baseline cardiovascular disease, diabetes, or cerebrovascular disease. Limitations inherent to claims-based analyses must be considered when interpreting these findings, such as the potential for miscoding or incomplete data, and the fact that the presence of a diagnosis code on a medical claim is not positive presence of disease. Furthermore, patients who suffered a fatal cardiovascular event at home during the study period, and therefore did not receive treatment, were not captured in this analysis.
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