December 3, 2010Journal of Internal Medicine
Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction and total mortality: the Copenhagen City Heart Study with 31 years of follow-up
Why the study?
Do high levels of nonfasting cholesterol and triglycerides increase the risk of myocardial infarction and total mortality in the general population?
Population
13,972 individuals randomly selected from the Danish general population, with less than 2% taking…
Comparison
High levels of nonfasting cholesterol and… vs Low levels of nonfasting cholesterol and…
Design
Cohort
Follow-up
31 years
Authors
Discussion
Loading...
Member takes
Implication
Elevated nonfasting lipids were associated with MI risk in this cohort; leaves open their incremental value for risk stratification or therapy guidance.
Key Points
- To compare the ability of elevated nonfasting cholesterol and nonfasting triglyceride levels to predict the risk of myocardial infarction and all-cause mortality over long-term follow-up.
- Prospective cohort design assessing a randomly selected Danish general population sample from 1976-1978 through 2007 (up to 31 years of follow-up).
- Enrolled 7,581 women and 6,391 men with 100% complete follow-up and less than 2% baseline lipid-lowering therapy use.
- Multivariate-adjusted Cox proportional hazard regression models evaluated associations between graded levels of nonfasting lipids, incident myocardial infarction, and all-cause mortality.
- For myocardial infarction, risks increased stepwise across cholesterol tiers up to HR 2.5 (95% CI: 1.6-4.0) in women and HR 5.3 (95% CI: 3.6-8.0) in men for levels ≥9 mmol/L, while triglycerides ≥5 mmol/L yielded an HR of 4.2 (95% CI: 2.5-7.2) in women and 2.1 (95% CI: 1.5-2.8) in men (all trend P < 0.0001).
- Increasing nonfasting cholesterol was not consistently associated with total mortality in women (trend P = 0.39) or men (trend P = 0.02).
- Progressively higher nonfasting triglycerides significantly predicted total mortality, reaching an HR of 2.0 (95% CI: 1.5-2.9) in women and 1.5 (95% CI: 1.2-1.7) in men for levels ≥5 mmol/L (both trend P < 0.0001).
Structured PICO
Do high levels of nonfasting cholesterol and triglycerides increase the risk of myocardial infarction and total mortality in the general population?
P
Population
13,972 individuals (7,581 women and 6,391 men) randomly selected from the Danish general population, with less than 2% taking lipid-lowering therapy.
I
Intervention
High levels of nonfasting cholesterol and triglycerides
C
Comparator
Low levels of nonfasting cholesterol (<5 mmol/L) and nonfasting triglycerides (<1 mmol/L)
O
Outcome
Myocardial infarction and total mortalityhard clinical
Stepwise increases in nonfasting triglycerides are strongly associated with both myocardial infarction and total mortality, whereas nonfasting cholesterol predicts myocardial infarction but not total mortality.
Cite This Study
Langsted et al. (2010) studied this question.