Association of four lipid components with mortality, myocardial infarction, and stroke in statin-naïve young adults: A nationwide cohort study

Aims Dyslipidaemia is a modifiable cardiovascular risk factor with prognostic implications. Current strategies for lipid management in young adults are largely based on expert recommendations. We investigated the risks of death and cardiovascular disease in relation to each lipid component to establ...

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Published in:European journal of preventive cardiology 2020-05, Vol.27 (8), p.870-881
Main Authors: Lee, Heesun, Park, Jun-Bean, Hwang, In-Chang, Yoon, Yeonyee E, Park, Hyo Eun, Choi, Su-Yeon, Kim, Yong-Jin, Cho, Goo-Yeong, Han, Kyungdo, Kim, Hyung-Kwan
Format: Article
Language:English
Subjects:
Adult
Age Factors
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Databases, Factual
Dyslipidemias - blood
Dyslipidemias - diagnosis
Dyslipidemias - mortality
Humans
Incidence
Lipids - blood
Male
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Prognosis
Republic of Korea - epidemiology
Retrospective Studies
Risk Assessment
Risk Factors
Stroke - blood
Stroke - diagnosis
Stroke - mortality
Triglycerides - blood
Young Adult
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Summary:Aims Dyslipidaemia is a modifiable cardiovascular risk factor with prognostic implications. Current strategies for lipid management in young adults are largely based on expert recommendations. We investigated the risks of death and cardiovascular disease in relation to each lipid component to establish evidence for primary prevention in young adults. Methods In this nationwide population-based cohort study, we analysed 5,688,055 statin-naïve subjects, aged 20–39 years, undergoing general health check-ups between 2009 and 2014. The endpoint was a composite of clinical events including death, myocardial infarction (MI), and stroke. We compared the incidence and risk of clinical events according to each lipid variable. Results During follow-up (median 7.1 years), clinical events occurred in 30,330 subjects (0.53%): 16,262 deaths (0.29%), 8578 MIs (0.15%), and 5967 strokes (0.10%). The risk of clinical events gradually increased with increasing total cholesterol (TC) and triglycerides and decreasing high-density lipoprotein cholesterol (HDL-C), largely driven by MI. Low-density lipoprotein cholesterol (LDL-C) had a J-shaped association with clinical events, showing the lowest risk for LDL-C of 84–101 mg/dL. Among lipid variables, triglycerides remained the sole independent predictor (adjusted hazard ratio, 1.20; p 
ISSN:2047-4873
2047-4881
DOI:10.1177/2047487319898571