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Measuring Biophysical and Psychological Stress Levels Following Visitation to Three Locations with Differing Levels of Nature
Published on: June 19, 2019
Visit-to-visit variability in low-density lipoprotein cholesterol is associated with adverse events in
Jun Gu1, Zhao-Fang Yin1, Jian-An Pan1
1Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine.
Insights
High variability in low-density lipoprotein cholesterol (LDL-C) levels is linked to increased cardiovascular events. This study found higher LDL-C variability predicts mortality and adverse outcomes in patients with non-obstructive coronary artery disease (CAD).
Area of Science:
- Cardiology
- Clinical Lipidology
- Public Health
Background:
- Visit-to-visit variability in low-density lipoprotein cholesterol (LDL-C) is increasingly recognized as a risk factor for cardiovascular events.
- The prognostic significance of LDL-C variability in patients with non-obstructive coronary artery disease (CAD) remains less understood.
Purpose of the Study:
- To investigate the association between visit-to-visit LDL-C variability and major adverse cardiovascular outcomes.
- Specifically, to examine the relationship with all-cause mortality, myocardial infarction (MI), and coronary revascularization in a cohort with non-obstructive CAD.
Main Methods:
- Retrospective analysis of 2,012 patients with non-obstructive CAD undergoing coronary angiography (2006-2010).
- Patients with at least three LDL-C measurements within the first two years were followed for five years.
- LDL-C variability assessed using standard deviation (SD) and coefficient of variation (CV); outcomes evaluated via multivariable Cox regression.
Main Results:
- Over five years, 4.92% experienced mortality and 7.65% had composite endpoints (MI or revascularization).
- Higher LDL-C variability (increased LDL-C-SD or LDL-C-CV) was associated with a greater incidence of mortality and composite endpoints.
- This association persisted independently of potential confounding factors.
Conclusions:
- Elevated visit-to-visit LDL-C variability is a significant predictor of long-term all-cause mortality and major adverse cardiovascular events in patients with non-obstructive CAD.
- These findings highlight the importance of LDL-C level stability in managing cardiovascular risk, even in the absence of obstructive disease.
Objective:
A higher visit-to-visit variability in low-density lipoprotein cholesterol (LDL-C) is associated with an increased frequency of cardiovascular events. We investigated the association between the visit-to-visit LDL-C variability and all-cause mortality, myocardial infarction (MI), and coronary revascularization in a population with non-obstructive coronary artery disease (CAD).
Methods:
From this retrospective cohort of individuals who underwent coronary angiography from 2006 to 2010, a total of 2.012 consecutive patients with non-obstructive CAD, who underwent three or more LDL-C determinations during the first 2 years, were identified and followed up for 5 years. The variability in the visit-to-visit LDL-C was measured by standard deviation (SD) and coefficient of variation (CV). The risk of all-cause mortality and composite endpoints, MI, and coronary revascularization were evaluated by a multivariable Cox regression analysis.
Results:
During a 5-year follow-up, a total of 99 (4.92%) mortality cases and 154 (7.65%) cases of composite endpoints were observed. The percentage of subjects who experienced mortality or composite endpoints was higher in those with a higher LDL-C-SD or LDL-C-CV level. The association between the LDL-C variability and clinical endpoints was regardless of possible confounding factors.
Conclusion:
Among the patients with non-obstructive CAD, a higher visit-to-visit LDL-C variability is associated with increasing all-cause mortality or composite endpoints during the long-term follow-up.
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