Low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) ≥160 mg/dL are independently associated with increased relative risk of cardiovascular disease (CVD) mortality in a low-risk cohort, according to a study published online Aug. 20 in Circulation.

Shuaib M. Abdullah, M.D., from the VA North Texas Medical Center in Dallas, and colleagues examined the long-term associations of various LDL-C and non-HDL-C thresholds and mortality in a cohort of 36,375 participants defined as low-risk for 10-year atherosclerotic CVD events (median age, 42).

The researchers identified 1,086 CVD and 598 coronary heart disease deaths during a median follow-up of 26.8 years. LDL-C categories of 100 to 129, 130 to 159, 160 to 189.9, and ≥190 mg/dL correlated with a significantly elevated risk of CVD death compared with LDL-C <100 mg/dL (hazard ratios, 1.4, 1.3, 1.9, and 1.7, respectively), and with mean reductions of 1.8, 1.1, 4.3, and 3.9 years free of CVD death, respectively. LDL-C categories of 160 to 189 and ≥190 mg/dL remained independently associated with CVD mortality after adjustment for atherosclerotic CVD risk factors (hazard ratios, 1.7 and 1.5, respectively). Using non-HDL-C <130 mg/dL as the reference, non-HDL-C 160 to 189, 190 to 219, and ≥220 mg/dL were significantly associated with CVD death, in multivariable-adjusted models, with hazard ratios of 1.3, 1.8, and 1.5, respectively.

"These findings may have implications for future cholesterol treatment paradigms," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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