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Visit-to-visit variability of lipid measurements as predictors of cardiovascular events

David D Waters1, Sripal Bangalore2, Rana Fayyad3

  • 1Division of Cardiology, UCSF at Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.

Journal of Clinical Lipidology
|January 10, 2018
PubMed

Insights

Visit-to-visit variability in high-density lipoprotein cholesterol (HDL-C), triglycerides, and low-density lipoprotein cholesterol (LDL-C) predicts cardiovascular events. Higher variability in triglycerides and LDL-C also predicts incident diabetes.

Area of Science:

  • Cardiology
  • Metabolic Health
  • Clinical Trials

Background:

  • Visit-to-visit variability in risk factors like blood pressure and LDL-C is linked to increased cardiovascular events.
  • Understanding lipid variability's impact is crucial for cardiovascular risk assessment.

Purpose of the Study:

  • To investigate if variability in HDL-C and triglyceride levels predicts coronary and cardiovascular events.
  • To analyze lipid variability in a clinical trial population with established coronary disease.

Main Methods:

  • Assessed intraindividual variability in fasting HDL-C, triglycerides, and LDL-C in 9572 patients from the Treating to New Targets trial.
  • Correlated lipid variability measures (e.g., average successive variability, standard deviation) with coronary events over a median 4.9-year follow-up.

Main Results:

  • Increased variability in HDL-C, triglycerides, and LDL-C was associated with a higher risk of coronary events (HRs ranging from 1.09 to 1.16).
  • Variability in triglycerides and LDL-C, but not HDL-C, predicted incident diabetes.
  • Similar associations were observed for cardiovascular events, stroke, and nonfatal myocardial infarction.

Conclusions:

  • Visit-to-visit variability in HDL-C, triglycerides, and LDL-C predicts coronary and cardiovascular events.
  • Variability in triglycerides and LDL-C also predicts incident diabetes, though underlying mechanisms require further investigation.
Abstract

Keywords:
Cardiovascular outcomesCholesterolHigh-density lipoprotein cholesterolLow-density lipoprotein cholesterolTriglyceridesVariability

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