Low Levels of Low-Density Lipoprotein Cholesterol and Mortality Outcomes in Non-Statin Users

Autor:	Jang Young Kim, Christopher D. Byrne, Ki Chul Sung, Ji Hye Huh, Dae-Sung Hyun, Jong-Young Lee, Seungho Ryu, Eleonora Scorletti, Sang-Baek Ko
Rok vydání:	2019
Předmět:	medicine.medical_specialty Statin medicine.drug_class lcsh:Medicine Low density lipoprotein cholesterol 030204 cardiovascular system & hematology Article low density lipoprotein cholesterol 03 medical and health sciences 0302 clinical medicine cardiovascular disease Internal medicine Epidemiology cancer Medicine 030212 general & internal medicine Lipoprotein cholesterol business.industry lcsh:R Cancer General Medicine medicine.disease mortality Increased risk Cohort lipids (amino acids peptides and proteins) business Validation cohort
Zdroj:	Journal of Clinical Medicine Volume 8 Issue 10 Journal of Clinical Medicine, Vol 8, Iss 10, p 1571 (2019)
ISSN:	2077-0383
DOI:	10.3390/jcm8101571
Popis:	We aimed to test the association between low-density lipoprotein cholesterol (LDL-C) and cardiovascular disease (CVD), cancer, and all-cause mortality in non-statin users. A total of 347,971 subjects in Kangbuk Samsung Health Study (KSHS.57.4% men, mean follow up: 5.64 ± 3.27 years) were tested. To validate these associations, we analyzed data from another cohort (Korean genome and epidemiology study, KoGES, 182,943 subjects). All subjects treated with any lipid-lowering therapy and who died during the first 3 years of follow up were excluded. Five groups were defined according to baseline LDL-C concentration (< 70, 70&ndash 99, 100&ndash 129, 130&ndash 159, &ge 160 mg/dL). A total of 2028 deaths occurred during follow-up in KSHS. The lowest LDL-C group (LDL < 70 mg/dL) had a higher risk of all-cause mortality (HR 1.95, 1.55&ndash 2.47), CVD mortality (HR 2.02, 1.11&ndash 3.64), and cancer mortality (HR 2.06, 1.46&ndash 2.90) compared to the reference group (LDL 120&ndash 139 mg/dL). In the validation cohort, 2338 deaths occurred during follow-up. The lowest LDL-C group (LDL < 70 mg/dL) had a higher risk of all-cause mortality (HR 1.81, 1.44&ndash 2.28) compared to the reference group. Low levels of LDL-C concentration are strongly and independently associated with increased risk of cancer, CVD, and all-cause mortality. These findings suggest that more attention is needed for subjects with no statin-induced decrease in LDL-C concentrations.
Databáze:	OpenAIRE
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