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Association of Low-Density Lipoprotein-Cholesterol and Its Small, Dense Phenotype with Six-Month Cardiovascular
Sufyan Ibrahim1, Anurupa Udupi1, Cleeta Rebeiro2
1Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Insights
This study found that neither low-density lipoprotein-cholesterol (LDL-C) nor small, dense LDL-C (sdLDL-C) levels significantly predicted cardiovascular events within six months. These lipid markers alone are insufficient for short-term cardiovascular risk assessment.
Area of Science:
- Cardiology
- Biochemistry
- Preventive Medicine
Background:
- Cardiovascular diseases (CVDs) are a leading global cause of mortality and morbidity.
- Elevated low-density lipoprotein-cholesterol (LDL-C) and small, dense LDL-C (sdLDL-C) are implicated as key modifiable risk factors in atherogenesis.
Purpose of the Study:
- To investigate the association between LDL-C and sdLDL-C levels and the incidence of CVDs over a six-month period.
- To evaluate the predictive efficacy of LDL-C and sdLDL-C for short-term cardiovascular events.
Main Methods:
- Lipid profiles were analyzed from 162 serum samples, including calculated LDL-C, direct LDL-C, and computed sdLDL-C.
- Patients' lipid profiles were correlated with cardiovascular outcomes over a six-month follow-up period.
- Binary logistic regression analysis was employed to assess the association between lipid parameters and cardiovascular events.
Main Results:
- No significant association was found between calculated LDL-C, direct LDL-C, or sdLDL-C and the occurrence of cardiovascular events (p > 0.05 for all).
- The median percentage of sdLDL-C was marginally higher in patients who experienced cardiovascular outcomes, but this difference was not statistically significant.
- The odds ratios for all tested lipid parameters were close to 1, indicating a lack of predictive power for short-term cardiovascular events.
Conclusions:
- Neither LDL-C nor sdLDL-C levels, when considered individually, serve as reliable indicators of cardiovascular morbidity within a six-month timeframe.
- Further research may be needed to explore combined lipid markers or other factors for improved short-term cardiovascular risk prediction.
Background:
Globally, cardiovascular diseases (CVDs) are the leading cause of death and disability. Elevated low-density lipoprotein-cholesterol (LDL-C) and more specifically, elevation of its small, dense phenotype (sdLDL-C) has been regarded as the key modifiable risk factors associated with atherogenesis. This study aimed to determine the association of LDL-C and sdLDL-C with the development of CVDs in the next six months to establish their predictive efficacy.
Methods:
A batch of 162 anonymized serum samples sent for analysis of lipid profile parameters, were classified into tests and controls based on the calculated LDL-C values obtained by Fried Ewald formula. Direct LDL-C was also estimated automatically using assay kits. Using the formula provided by Srisawasdi et al., sdLDL-C was then computed for all samples. Six months later, samples were deanonymized, and the lipid profiles were compared with cardiovascular outcomes of these patients, to determine which parameter had the greatest correlation.
Results:
Four control group patients and three test group patients developed the outcome (any cardiovascular event) during the 6-month follow-up period. Binary logistic regression analysis showed that none of the lipid profile parameters: calculated LDL-C (OR= 0.99; 95% CI= 0.97-1.01; p= 0.826), direct LDL-C (OR= 0.99; 95% CI= 0.97-1.01; p= 0.818) or sdLDL-C (OR= 0.99; 95% CI= 0.93-1.04; p= 0.734), were significantly associated with the occurrence of outcome. The median % sdLDL-C both with respect to direct and calculated LDL-C was slightly higher in patients with the outcome.
Conclusion:
The levels of LDL-C or its individual phenotypes may not be used singly as indicator of cardiovascular morbidity in the next six months.
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