Association between very high HDL-C levels and cardiovascular mortality

Figures

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  Fig. 1. Flow Diagram of Study Population Selection and Cohort Derivation. This figure illustrates the identification of adult patients from the Abbas Institute of Medical Sciences electronic health records, the application of inclusion and exclusion criteria, and the stepwise selection of the final study cohort of 3,758 individuals included in the analysis

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  Fig. 2. Kaplan–Meier cardiovascular survival curves stratified by HDL-C categories.Survival probabilities over a maximum follow-up of 8 years are shown for five baseline HDL-C categories: Very Low (< 30 mg/dL), Low (30–49 mg/dL), Normal (50–69 mg/dL), High (70–89 mg/dL), and Very High (≥ 90 mg/dL in men or ≥ 110 mg/dL in women). Individuals with very high HDL-C demonstrated reduced cardiovascular survival compared with those with normal HDL-C levels. Inter-group differences were statistically significant by log-rank testing, supporting a U-shaped association between HDL-C and cardiovascular mortality

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  Fig. 3. Forest Plot of Subgroup Analysis for Very High HDL-C and Cardiovascular Mortality. The figure shows adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between very high high-density lipoprotein cholesterol (HDL-C) levels (≥ 90 mg/dL in men or ≥ 110 mg/dL in women) and cardiovascular mortality across predefined clinical subgroups. Subgroups included sex, age, diabetes status, and statin use. Red circles indicate point estimates of HRs, and horizontal lines represent the 95% CIs. A vertical dashed line at HR = 1.0 denotes the reference (no effect). The association between very high HDL-C and increased cardiovascular mortality was more pronounced in diabetics, older individuals (≥ 60 years), and non-statin users, with confidence intervals not crossing unity