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Cholesterol variability and the risk of mortality, myocardial infarction, and stroke: a nationwide population-based

Mee Kyoung Kim1, Kyungdo Han2, Hun-Sung Kim3,4

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #10, 63-ro, Yeongdeungpo-gu, 07345 Seoul, Korea.

European Heart Journal
|October 26, 2017
PubMed

Insights

High cholesterol variability is linked to increased risk of death, heart attack, and stroke in the general population. This finding highlights cholesterol variability as a significant independent risk factor for adverse cardiovascular events.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Biostatistics

Background:

  • Visit-to-visit variability in cholesterol levels is a potential predictor of adverse cardiovascular events in patients with coronary artery disease.
  • The association between cholesterol variability and health outcomes in the general population remains largely unknown.

Purpose of the Study:

  • To investigate the association between total cholesterol (TC) variability and the risk of all-cause mortality, myocardial infarction (MI), and stroke in the general population.

Main Methods:

  • Utilized data from 3,656,648 subjects in the Korean National Health Insurance System cohort with at least three health examinations between 2002 and 2007.
  • Measured total cholesterol variability using coefficient of variation (CV), standard deviation (SD), and variability independent of the mean (VIM).
  • Followed subjects for a median of 8.3 years to record outcomes of all-cause mortality, MI, and stroke.

Main Results:

  • A linear association was observed between higher TC variability and increased risk of all-cause mortality, MI, and stroke.
  • The highest quartile of TC variability (CV) was associated with a 1.26-fold increased risk of all-cause mortality, 1.08-fold for MI, and 1.11-fold for stroke, independent of mean TC levels and lipid-lowering medication use.
  • Results remained consistent across different variability measures (SD, VIM) and sensitivity analyses.

Conclusions:

  • High variability in lipid levels, specifically total cholesterol, is associated with adverse health outcomes in the general population.
  • Cholesterol variability should be considered an important risk factor for cardiovascular events and mortality.
Abstract

Keywords:
CholesterolMortalityMyocardial infarctionStrokeVariability

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