Value of total cholesterol readings earlier versus later in life to predict cardiovascular risk.

Autor:	Leiherer A; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, Feldkirch A-6800, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Medical Central Laboratories, Feldkirch, Austria. Electronic address: vivit@lkhf.at., Ulmer H; Agency for Preventive and Social Medicine, Bregenz, Austria; Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria., Muendlein A; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, Feldkirch A-6800, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein., Saely CH; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, Feldkirch A-6800, Austria; Department of Internal Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein., Vonbank A; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, Feldkirch A-6800, Austria; Department of Internal Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria., Fraunberger P; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Medical Central Laboratories, Feldkirch, Austria., Foeger B; Agency for Preventive and Social Medicine, Bregenz, Austria., Brandtner EM; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, Feldkirch A-6800, Austria., Brozek W; Agency for Preventive and Social Medicine, Bregenz, Austria., Nagel G; Agency for Preventive and Social Medicine, Bregenz, Austria; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany., Zitt E; Agency for Preventive and Social Medicine, Bregenz, Austria; Department of Internal Medicine III, Academic Teaching Hospital Feldkirch, Feldkirch, Austria., Drexel H; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, Feldkirch A-6800, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Drexel University College of Medicine, Philadelphia, PA, United States; Department of Internal Medicine, Academic Teaching Hospital Bregenz, Bregenz, Austria., Concin H; Agency for Preventive and Social Medicine, Bregenz, Austria.
Jazyk:	angličtina
Zdroj:	EBioMedicine [EBioMedicine] 2021 May; Vol. 67, pp. 103371. Date of Electronic Publication: 2021 May 14.
DOI:	10.1016/j.ebiom.2021.103371
Abstrakt:	Background: Prognostic implications of blood cholesterol may differ at different stages of life. This cohort study compares the value of total cholesterol (TC) readings earlier versus later in life for the prediction of coronary atherosclerosis, cardiovascular events, and cardiovascular death. Methods: In a cardiovascular observation study (CVOS) we performed coronary angiography and prospectively recorded cardiovascular events in 1090 patients over up to 19 years. These patients had participated in a health survey (HS) 15 years prior to the CVOS baseline. TC was measured twice, first at the earlier HS and then later at CVOS recruiting. Findings: Patients in the highest versus the lowest TC-category of the HS had an OR of 4.30 [2.41-7.65] for significant CAD at angiography, a HR of 1.74 [1.10-2.76] for cardiovascular events, and a HR of 7.55 [1.05-54.49] for cardiovascular death after multivariate adjustment. In contrast, TC as measured at the baseline of the CVOS was neither significantly associated with significant CAD (OR= 0.75 [0.49-1.13]) nor with cardiovascular events or death during follow-up (HR= 0.86 [0.62-1.18] and 0.79 [0.41-1.53], respectively). Moreover, the ESC/EAS-SCORE was found to be more powerful in predicting cardiovascular mortality when using earlier instead of later TC, with a continuous net reclassification improvement of 0.301 (p<0.001). Interpretation: Early measurement not only enables early intervention in keeping with the concept of lifelong exposure to atherogenic lipoproteins. These data also suggest that cardiovascular risk prediction is more accurate if using earlier in life TC readings. Funding: The present study did not receive any particular funding. Competing Interests: Declaration of Competing Interest A.L. has nothing to disclose, H.U. has nothing to disclose, A.M. has nothing to disclose, C.H.S. has nothing to disclose, A.V. has nothing to disclose, P.F. has nothing to disclose, B.F. has nothing to disclose, E.M.B. has nothing to disclose, W.B. has nothing to disclose, G.N. has nothing to disclose, E.Z. has nothing to disclose, H.D. has nothing to disclose, and H.C. has nothing to disclose. (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu