Non-HDL-C: new tool uses it to assess long-term CVD risk

Takeaway

• Non-high-density lipoprotein cholesterol (HDL-C) is linked to long-term cardiovascular disease (CVD) risk, according to the authors of this multinational study.

Why this matters

• These authors offer a “simple” tool that uses non-HDL-C for assessing risk and evaluates possible benefits of starting lipid-reducing therapy.

Key results

• With increasing serum non-HDL-C, 30-year CVD rates increased:
  • 7.7% with <2.6 mmol/L vs 33.7% with ≥5.7 mmol/L in women;
  • 12.8% with <2.6 mmol/L vs 43.6% with ≥5.7 mmol/L in men (P<.0001).
• Steepest risk increases seen in those under age 45 years at baseline.
• They found that reducing non-HDL-C by 50% decreased CVD event risk by age 75 years, with increasing benefit with earlier reductions.

Study design

• Data from the Multinational Cardiovascular Risk Consortium, 19 countries in Europe, Australia, and North America.
• 398,846 participants from 38 cohorts; of these, 199,415 were in the derivation cohort and 199,431 were used for validation.
• Funding: EU Framework Programme, others.

Limitations

• Only baseline lipid values used.
• Most participants were of European ancestry.