The association between cholesterol cholelithiasis and coronary heart disease in Framingham, Massachusetts

Area of Science:

• Cardiovascular Medicine
• Gastroenterology
• Epidemiology

Background:

• A link between cholesterol gallstones and atherosclerosis has been suspected but not definitively proven.
• Previous studies have not adequately established a causal relationship.

Purpose of the Study:

• To investigate the relationship between diagnosed cholesterol gallstone disease and subsequent coronary heart disease.
• To determine if cholesterol gallstones are an independent risk factor for coronary heart disease.

Main Methods:

• Utilized prospectively collected medical records from 5,209 participants in the Framingham Heart Study (followed since 1952).
• Employed logistic multiple regression analyses, accounting for time ordering and eight standard coronary disease risk factors.
• Performed preliminary univariate analyses to assess initial associations.

Main Results:

• A modest positive association was found between cholesterol gallstones and coronary heart disease in men, but not in women.
• Logistic regression confirmed this association in men after adjusting for confounding factors.
• The findings suggest cholesterol gallstones may indicate an unfavorable lipoprotein profile in men.

Conclusions:

• Male patients with cholesterol gallstones are at an increased risk for subsequent coronary heart disease.
• These findings have clinical implications for monitoring male gallstone patients for cardiovascular disease.
• This longitudinal cohort study provides the first established link between cholesterol gallstones and coronary heart disease.