title: Non-high-density lipoprotein cholesterol and coronary artery calcium progression in a multiethnic US population.
abstract: Non-high-density lipoprotein cholesterol (non-HDLc) is an independent predictor of cardiovascular disease risk, with elevated levels signifying an increased risk beyond low-density lipoprotein. Previous data have shown inconsistent association of lipid subfractions with progression of coronary artery calcium (CAC), a surrogate marker of incident cardiovascular disease. We sought to evaluate the association between non-HDLc and development (incident) and progression of CAC in a cohort of multiethnic asymptomatic subjects. The cohort (n = 5,705) was derived from the limited access data set of the Multi-Ethnic Study of Atherosclerosis obtained from the National Heart Lung and Blood Institute. Multivariable regression analysis was performed to derive the association between non-HDLc and incident CAC (n = 2,927) and non-HDLc and progression of CAC (n = 2,778). In the population without CAC at baseline, non-HDLc, especially >190 mg/dl, was independently associated with incident CAC (relative risk 1.40, 95% confidence interval 1.09 to 1.79, p = 0.008) after adjustments with age, gender, race, systolic blood pressure, antihypertension medication use, smoking, diabetes, lipid-lowering therapy use, follow-up duration, and waist-hip ratio. Similarly, among those with CAC at baseline, non-HDLc levels >190 mg/dl were associated with significant CAC progression in the overall population (β 16.4, 95% confidence interval -5.63 to 27.2, p = 0.003) after adjustments. In conclusion, non-HDLc levels, especially >190 mg/dl, are consistently associated with increased risk of CAC progression. Our results suggest that among lipid fractions, non-HDLc may be best suited for the prediction of future CAC progression.
authors: Division of Cardiology, Department of Medicine, Wayne State University, Detroit Medical Center, Detroit, Michigan.
authors: Sandip K
authors: SK
authors: Zalawadiya
authors: Division of Cardiology, Department of Medicine, Wayne State University, Detroit Medical Center, Detroit, Michigan.
authors: Vikas
authors: V
authors: Veeranna
authors: Division of Cardiology, Department of Medicine, Wayne State University, Detroit Medical Center, Detroit, Michigan.
authors: Sidakpal
authors: S
authors: Panaich
authors: Division of Cardiology, Department of Medicine, Wayne State University, Detroit Medical Center, Detroit, Michigan.
authors: Anupama
authors: A
authors: Kottam
authors: Division of Cardiology, Department of Medicine, Wayne State University, Detroit Medical Center, Detroit, Michigan. Electronic address: lafonso@med.wayne.edu.
authors: Luis
authors: L
authors: Afonso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000208:ethnology; D008076:Cholesterol, HDL / Q000097:blood*; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000208:ethnology; D018450:Disease Progression; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL