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Analysis of the Correlation between Hypercholesterolemia and Increased Cardiovascular Morbidity and Mortality among
Noam Nagel1, Ruth Rahamimov1,2,3, Dana Bielopolski1,2
1Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Insights
A high LDL-C/HDL-C ratio predicts increased cardiovascular risk in kidney transplant recipients (KTRs). This finding highlights the ratio
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Hypercholesterolemia's impact on cardiovascular disease (CVD) in kidney transplant recipients (KTRs) is not well-defined.
- Characterizing cholesterol profiles and their association with CVD in KTRs is crucial.
Purpose of the Study:
- To investigate the correlation between abnormal cholesterol levels and cardiovascular morbidity and mortality in KTRs.
- To identify specific lipid markers predictive of adverse cardiovascular outcomes in this population.
Main Methods:
- Retrospective cohort study of 737 adult KTRs transplanted between 2005 and 2014.
- Primary outcome: Major Adverse Cardiovascular Events (MACE). Secondary outcome: MACE and all-cause mortality.
- Multivariate time-varying Cox models analyzed MACE and mortality risk based on time-weighted average cholesterol levels.
Main Results:
- High LDL-C levels correlated with increased MACE risk (HR 1.008 per mg/dL).
- Low HDL-C levels showed no significant association with MACE (HR 0.992 per mg/dL).
- A higher LDL-C/HDL-C ratio significantly increased MACE risk (HR 1.502 per unit) and the composite outcome (HR 1.35 per unit).
Conclusions:
- The LDL-C/HDL-C ratio is a significant predictor of cardiovascular morbidity and mortality in KTRs.
- This ratio serves as a valuable marker for cardiovascular risk assessment in KTRs.
- Findings support interventions to manage hypercholesterolemia in this high-risk group.
Introduction:
The correlation between hypercholesterolemia and cardiovascular disease in kidney transplant recipients (KTRs) remains uncertain. We sought to characterize the association between abnormal cholesterol profiles and cardiovascular morbidity and mortality in this unique population.
Methods:
This retrospective cohort study was conducted at a single center and included all adult KTR, transplanted between January 2005 and April 2014. The primary outcome was major adverse cardiovascular events (MACE) while the secondary outcome was the composite outcome of MACE and all-cause mortality. Exposure to abnormal cholesterol levels was calculated using a time-weighted average calculation. MACE and mortality risk were analyzed using a multivariate time-varying Cox model.
Results:
The final cohort comprised 737 KTR, with a median follow-up of 2,920 days. A total of 126 patients (17.1%) experienced MACE. High LDL-C levels and MACE risk were correlated by multivariate analysis (HR 1.008 per mg/dL, 95% CI: 1.001-1.016), while low HDL-C levels were not significantly associated with MACE (HR 0.992 per mg/dL, 95% CI: 0.976-1.009). A higher LDL-C/HDL-C ratio was significantly associated with an increased risk of MACE in multivariate analyses (HR 1.502 per unit, 95% CI: 1.147-1.968), and also correlated with the composite outcome (HR 1.35 per unit, 95% CI: 1.06-1.71).
Conclusions:
A high LDL-C/HDL-C ratio is predictive of an increased risk of cardiovascular morbidity and mortality in KTRs. These findings emphasize the significance of the LDL-C/HDL-C ratio as a valuable marker of cardiovascular risk and support current recommendations to improve hypercholesterolemia in this high-risk group.
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