Evaluation of non-HDL cholesterol as a predictor of non-fatal cardiovascular events in a prospective population cohort

• Published in: Clínica e investigación en arteriosclerosis (Internet, English ed.) English ed.), 2018-03, Vol.30 (2), p.64-71
• Main Authors: Carbayo Herencia, Julio A., Simarro Rueda, Marta, Palazón Bru, Antonio, Molina Escribano, Francisca, Ponce García, Isabel, Artigao Ródenas, Luis Miguel, Caldevilla Bernardo, David, Divisón Garrote, Juan A., Gil Guillén, Vicente Francisco
• Format: Article
• Language: English
• Subjects: Aterosclerosis; Atherosclerosis; Cardiovascular diseases; Cohort studies; Enfermedad cardiovascular; Estudio de cohortes; Factores de riesgo; Morbidity; Morbilidad; Risk factors
• ISSN: 2529-9123; 2529-9123
• DOI: 10.1016/j.artere.2017.10.003

Non-HDL cholesterol (non-HDL-C) is becoming relevant both in its participation in cardiovascular risk assessment and as a therapeutic target. The objective of the present study was to assess the independent predictive capacity of both non-HDL-C and LDL-C (the main priority in dyslipidemias to reduce cardiovascular risk), in cardiovascular morbidity in a population-based sample. A prospective cohort study involving 1186 individuals in the non-HDL-C group and 1177 in the LDL-C group, followed for 10.7years (SD=2.2), who had not had any previous cardiovascular event. The predictor variables included in the adjustment were: gender, age, arterial hypertension, diabetes mellitus, smoker status and non-HDL-C in one group. In the other group, consisting of patients presenting TG levels of 400mg/dl, non-HDL-C was replaced by LDL-C. Survival curves (Kaplan–Meier) were calculated and two Cox regression models were applied, one for each group. Non-HDL-C group presented 6.2% of non-fatal cardiovascular episodes during follow-up and the LDL-C group 6.0%. After adjustment, for each 30mg/dl increase in non-HDL-C, the incidence of new non-fatal cardiovascular events increased by 31% (HR=1.31, 95% CI: 1.06–1.61; p=0.018) and in the LDL-C group by 27% (HR=1.27, 95% CI: 0.97–1.61, p=0.068). After a follow-up of 10.7years, non-HDL-C has been shown in our population as a prognostic factor of non-fatal cardiovascular disease, but not LDL-C, although its HR is close to statistical significance. El colesterol no transportado por las lipoproteínas de alta densidad (c-no-HDL) está adquiriendo relevancia en su participación en la valoración del riesgo cardiovascular y como diana terapéutica. El objetivo del presente estudio ha sido valorar la capacidad predictiva independiente, tanto del c-no-HDL como del colesterol de las lipoproteínas de baja densidad (cLDL), principal prioridad en las dislipidemias para reducir el riesgo cardiovascular (RCV), en la morbilidad de causa cardiovascular, en una muestra de origen poblacional. El diseño del estudio corresponde a una cohorte prospectiva en la que han participado 1.186 individuos en el grupo c-no-HDL y 1.177 en el grupo cLDL, seguidos durante 10,7años (DE=2,2), los cuales no habían padecido ningún episodio cardiovascular (CV) previo. Las variables predictoras incluidas en el ajuste han sido: género, edad, hipertensión arterial, diabetes mellitus, estado de fumador y c-no-HDL en un grupo. En el otro grupo, formado por pacientes que present