Relation between plaque progression and low-density lipoprotein cholesterol during aging as assessed with serial long-term (> or =12 months) follow-up intravascular ultrasound of the left main coronary artery.
Because of the clinical benefit of lipid lowering in older patients, we hypothesized that the relation between low-density lipoprotein (LDL) cholesterol serum levels and coronary plaque progression may persist throughout aging. We analyzed serial intravascular ultrasound (IVUS) data of 60 left main stems (18 +/- 9 months apart) and evaluated the relation between LDL cholesterol levels and coronary plaque progression at different ages. The population (n = 60) was divided into 3 groups according to age: tertile 1 (n = 20) was a mean age of 48 +/- 6 years (median 51, range 33 to 55), tertile 2 (n = 20) was a mean age of 58 +/- 2 years (median 59, range 55 to 61), and tertile 3 (n = 20) was a mean age of 66 +/- 6 years (median 65, range 61 to 83). Between groups, there was no significant difference in non-age-related demographics, clinical data, lipid profiles, or medications (e.g., statins). There was a positive linear relation between LDL cholesterol and annual changes in plaque plus media area in all age tertiles, which was statistically significant in tertiles 2 and 3 (r = 0.56, p <0.01; r = 0.50, p <0.02) and showed a strong trend in tertile 1 (r = 0.41, p = 0.07). The estimated LDL cholesterol thresholds, which, as determined by regression analysis, would correspond to no plaque progression, were 74, 60, and 78 mg/dl, respectively, in tertiles 1, 2, and 3. In conclusion, serial IVUS data in left main coronary arteries suggest that the relation between LDL cholesterol serum levels and plaque progression persists during aging.
Hartmann
Marc
M
The Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands.
von Birgelen
Clemens
C
Mintz
Gary S
GS
van Houwelingen
Gert K
GK
Eggebrecht
Holger
H
Böse
Dirk
D
Wieneke
Heinrich
H
Verhorst
Patrick M J
PM
Erbel
Raimund
R
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D008078:Cholesterol, LDL / Q000097:blood*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018084:Ultrasonography, Interventional
D008078:Cholesterol, LDL