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Lipid Variability and the Risk of Incident Peripheral Artery Disease.
Ying-Chang Tung1,2, Tsung-Han Tsai1, Yu-Jui Hsieh1
1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Summary
High variability in high-density lipoprotein cholesterol (HDL-C) levels is linked to increased peripheral artery disease (PAD) risk. This finding highlights HDL-C variability as a potential predictor for PAD development.
Area of Science:
- Cardiovascular Medicine
- Lipid Metabolism
- Atherosclerosis Research
Background:
- Lipid variability is increasingly recognized for its role in cardiovascular disease outcomes.
- Peripheral artery disease (PAD) is a significant manifestation of atherosclerosis.
Purpose of the Study:
- To investigate the association between lipid variability and the risk of developing incident peripheral artery disease (PAD).
Main Methods:
- Analysis of a large cohort (93,948 patients) from the Chang Gung Research Database in Taiwan with hyperlipidemia.
- Assessment of annual lipid measurements (total cholesterol, LDL-C, HDL-C, triglycerides) and their visit-to-visit variability over 4 years.
- Follow-up for incident PAD development until December 31, 2019, with a mean follow-up of 5.9 years.
Main Results:
- A total of 2,735 patients (2.5%) developed PAD during the follow-up period.
- Mean lipid levels showed a significant association with incident PAD.
- Higher average real variability (ARV) in high-density lipoprotein cholesterol (HDL-C) was independently associated with an increased risk of PAD (aHR 1.13, P=0.002).
Conclusions:
- Visit-to-visit variability in HDL-C is significantly associated with incident PAD risk.
- This association is independent of traditional atherosclerotic risk factors, mean lipid levels, and lipid-lowering therapy.
- HDL-C variability serves as a potential novel risk indicator for PAD.
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