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Visit-to-visit variability in low-density lipoprotein cholesterol is associated with adverse events in non-obstructive coronary artery disease [Anatol J Cardiol]
Anatol J Cardiol. 2019; 22(3): 117-124 | DOI: 10.14744/AnatolJCardiol.2019.26428  

Visit-to-visit variability in low-density lipoprotein cholesterol is associated with adverse events in non-obstructive coronary artery disease

Jun Gu1, Zhao-fang Yin1, Jian-an Pan1, Jun-feng Zhang1, Chang Qian Wang1
1Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine
2Department of Cardiology, Shanghai Minhang Hospital, Fudan University; Shanghai-People's Republic of China

Objective: A higher visit-to-visit variability in low-density lipoprotein cholesterol (LDL-C) is associated with an increased frequency of cardiovascular events. We investigated the association between the visit-to-visit LDL-C variability and all-cause mortality, myocardial infarction (MI), and coronary revascularization in a population with non-obstructive coronary artery disease (CAD).
Methods: From this retrospective cohort of individuals who underwent coronary angiography from 2006 to 2010, a total of 2.012 consecutive patients with non-obstructive CAD, who underwent three or more LDL-C determinations during the first 2 years, were identified and followed up for 5 years. The variability in the visit-to-visit LDL-C was measured by standard deviation (SD) and coefficient of variation (CV). The risk of all-cause mortality and composite endpoints, MI, and coronary revascularization were evaluated by a multivariable Cox regression analysis.
Results: During a 5-year follow-up, a total of 99 (4.92%) mortality cases and 154 (7.65%) cases of composite endpoints were observed. The percentage of subjects who experienced mortality or composite endpoints was higher in those with a higher LDL-C-SD or LDL-C-CV level. The association between the LDL-C variability and clinical endpoints was regardless of possible confounding factors.
Conclusion: Among the patients with non-obstructive CAD, a higher visit-to-visit LDL-C variability is associated with increasing all-cause mortality or composite endpoints during the long-term follow-up.

Keywords: Coronary artery disease, low-density lipoprotein, cholesterol, variability, cardiovascular outcomes.


Jun Gu, Zhao-fang Yin, Jian-an Pan, Jun-feng Zhang, Chang Qian Wang. Visit-to-visit variability in low-density lipoprotein cholesterol is associated with adverse events in non-obstructive coronary artery disease. Anatol J Cardiol. 2019; 22(3): 117-124

Corresponding Author: Chang Qian Wang, China


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