Residual Cardiovascular Risk Associated with Non-HDL-C in Statin-Treated Patients: Data from the Gulf Triglyceride...

Area of Science:

• Cardiology
• Public Health
• Lipid Metabolism

Background:

• Lowering non-high-density lipoprotein cholesterol (non-HDL-C) is linked to reduced cardiovascular disease (CVD) risk.
• Data on non-HDL-C targets and residual CVD risk in the Arabian Gulf are limited.
• Very high-risk patients on statins may still have residual CVD risk despite controlled LDL-C.

Purpose of the Study:

• To investigate the association between failure to achieve non-HDL-C targets and residual CVD risk.
• To assess this relationship in very high-risk patients in the Arabian Gulf region.
• To evaluate the impact of non-HDL-C targets on CVD events in patients on statin therapy.

Main Methods:

• Retrospective study of patients aged >45 years with established CVD or diabetes across 5 Arabian Gulf countries.
• Inclusion criteria: LDL-C <1.8 mmol/L, triglycerides <4.5 mmol/L on lipid-lowering therapy.
• Analysis using adjusted Cox regression to compare CVD event risk based on non-HDL-C target achievement.

Main Results:

• 22% of patients (521/2344) did not achieve the non-HDL-C target (<2.6 mmol/L).
• Patients achieving the non-HDL-C goal had a 25% lower risk of subsequent CVD events (HR, 0.75; 95% CI: 0.58-0.97; P=.028).
• Failure to achieve non-HDL-C targets was associated with significantly higher residual CVD risk.

Conclusions:

• Failure to achieve non-HDL-C targets is associated with increased residual CVD risk in very high-risk patients in the Arabian Gulf.
• Maintaining non-HDL-C goals is important for CVD risk reduction, even with controlled LDL-C.
• Further strategies may be needed to optimize non-HDL-C levels in this population.