Abstract P122: The Clinical Impact of TC/HDL-C Discordance With LDL-C and Non-HDL-C: 20 Year Follow-up of the Atherosclerosis Risk in Communities (ARIC) Study
Introduction: TheTotal to High-Density Lipoprotein cholesterol (TC/HDL-C) ratio may carry unique prognostic information for atherosclerotic cardiovascular diseases (ASCVD) risk beyond the more commonly used measures of low-density lipoprotein (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C). Information regarding patient-level discordance between these lipid parameters may be clinically relevant in refining risk stratification.
Methods: We studied 14,393 ARIC participants free of ASCVD at baseline who were mean age 54 years, 56% women, and 25% black. Lipids were measured at baseline (1987-1989) and at four additional visits. TC/HDL-C discordance with non-HDL-C and LDL-C (defined by categories above/below the median) was updated at each visit. Participants were followed for ASCVD events through end of 2013, with mean follow-up of 20 years. Multivariable-adjusted Cox hazard models were used to estimate for ASCVD risk for each category.
Results: Among participants with low LDL-C <median, a discordantly high TC/HDL-C ≥median was associated with a greater ASCVD risk compared to those concordantly low for both TC/HDL-C and LDL-C. Those with low non-HDL but a discordantly high TC/HDL-C also had greater ASCVD risk than those concordantly low for both measures (Table).
Conclusions: In a primary prevention population,the TC/HDL-C ratio provides additional prognostic information to non-HDL-C and LDL-C. Individuals who reach low levels of LDL-C or non-HDL-C may still be at high risk of ASCVD if TC/HDL-C is discordantly high.
Author Disclosures: R. Quispe: None. M.B. Elshazly: None. D. Zhao: None. P.P. Toth: G. Consultant/Advisory Board; Modest; Atherotech Diagnostic Laboratory, Amgen, AstraZeneca, Glaxo-SmithKline. A.D. Sniderman: None. R. Puri: None. S.S. Virani: None. S.S. Martin: B. Research Grant; Modest; PJ Schafer Cardiovascular Research Fund, American Heart Association, Aetna Foundation, and Google. G. Consultant/Advisory Board; Modest; Pressed Juicery, Abbott Nutrition, Quest Diagnostics, and the Pew Research Center. S.R. Jones: G. Consultant/Advisory Board; Modest; Sanofi and Regeneron. E.D. Michos: None.
- © 2017 by American Heart Association, Inc.