Abstract 590: LDL Particle Number is Associated With Incident Atherosclerotic Cardiovascular Disease Among Persons With a 10-Year Risk of <7.5%
Background: The 2013 AHA/ACC guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) risk recommend that individuals with LDL-C between 70 and 190 mg/dL should receive statin therapy if their 10-year risk of ASCVD is >7.5%. LDL particle number is not included in the calculation of 10-year risk, but it has been reported to be to be associated with ASCVD. Therefore we asked whether LDL particle number was associated with ASCVD events among those whose 10-year risk does not exceed the 7.5% threshold for statin therapy.
Methods: We determined LDL particle number by ion mobility in a prospective, population-based study of 4755 men and women from the Malmö Diet and Cancer Study Cardiovascular Cohort. Among the 1928 participants who at baseline had <7.5% 10-year ASCVD risk, LDL-C <190mg/dL, and were free of ASCVD and diabetes, Cox proportional hazards models were used to analyze the association between LDL particle number and incident ASCVD.
Results: During a median of 16.4 years of follow-up, 89 participants had a first incident ASCVD event. LDL particle number was associated with ASCVD events (P=0.003) after adjustment for age, sex, LDL-C, HDL-C, triglycerides, systolic and diastolic blood pressure, use of antihypertensive medication, and smoking. Participants in the top LDL particle number tertile had more than two-fold increased risk of ASCVD (HR = 2.50; 95%CI 1.32 to 4.74) in the fully adjusted model when compared with the bottom tertile. LDL-C, HDL-C, and triglycerides were not associated with incident ASCVD in these 1928 participants (P>0.25) in models that did or did not include LDL particle number.
Conclusion: Among those who do not meet the 2013 AHA/ACC statin treatment guidelines, those in the top LDL particle number tertile were at elevated risk of ASCVD events, a risk that was independent of traditional risk factors, including standard lipid measurements.
Author Disclosures: O. Melander: None. D. Shiffman: Employment; Significant; Quest Diagnostics. M.P. Caulfield: Employment; Significant; Quest Diagnostics. J.Z. Louie: Employment; Significant; Quest Diagnostics. C.M. Rowland: Employment; Significant; Quest Diagnostics. J.J. Devlin: Employment; Significant; Quest Diagnostics. R.M. Krauss: Research Grant; Modest; Sanofi-Regeneron. Research Grant; Significant; Quest Diagnostics. Honoraria; Modest; Merck, Janssen, Amarin, Celera, National Lipid Association. Consultant/Advisory Board; Modest; Merck, Janssen, Amarin, Celera, National Lipid Association. Other; Significant; Patents on ion mobility procedure.
- © 2014 by American Heart Association, Inc.