Key result
Each unit increase in the LDL-C/HDL-C ratio was significantly associated with a 61% increased risk of carotid plaques in patients with coronary heart disease.
Why the study?
Evidence on the relationship between the LDL-C/HDL-C ratio and carotid plaques remains limited, particularly regarding how a healthy lifestyle modifies this risk in patients with CHD.
Does a high LDL-C/HDL-C ratio increase the risk of carotid plaques in patients with CHD, and does a healthy lifestyle mitigate this risk?
Cohort (n=9,426)
Yes
Does a high LDL-C/HDL-C ratio increase the risk of carotid plaques in patients with CHD, and does a healthy lifestyle mitigate this risk?
Odds Ratio: 1.61 (95% CI 1.43–1.84)
p-value: p=<0.001
A higher LDL-C/HDL-C ratio is associated with an increased risk of carotid plaques in CHD patients, but adherence to a healthy lifestyle (non-smoking, non-drinking) significantly attenuates this risk.
May inform carotid plaque risk assessment in CHD; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Evidence on the relationship between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and carotid plaques remains limited. This study aimed to examine the association between LDL-C/HDL-C and carotid plaques in participants with coronary heart disease (CHD) and to further explore the extent to which a healthy lifestyle reduces the risk of LDL-C/HDL-C-related carotid plaques. METHODS: This large-scale and multi-centre retrospective study included 9426 CHD patients (aged 35-75 years) between January 1, 2014 and September 30, 2020. The LDL-C/HDL-C values were converted to the following tertiles: lowest (< 2.15), middle (2.15-3), and highest (> 3). Healthy lifestyle-related factors referred to whether or not the participant was a non-smoker and non-drinker. Participants were divided into an unfavourable group (those who did not adhere to healthy lifestyle factors), intermediate (only one unhealthy factor), and favourable (neither of the two unhealthy factors). Logistic regression was used for statistical analyses. RESULTS: Of the 9426 participants, 6989 (74.15%) CHD patients had carotid plaques. After adjustment for confounders, each unit increase in the LDL-C/HDL-C was significantly associated with carotid plaques (OR: 1.61; 95%CI: 1.43-1.84; P < 0.001). Multivariate logistic regression revealed that carotid plaques risk for the highest tertile (> 3) was 1.18 times that of the lowest quartile (< 2.15). Compared with an unfavourable lifestyle, an intermediate or a favourable lifestyle was associated with a significant 30% (OR: 0.70; 95%CI: 0.64-0.78; P < 0.001) or 67% (OR: 0.33; 95%CI: 0.29-0.37; P < 0.001) reduction in carotid plaques risk, respectively, among CHD patients with high LDL-C/HDL-C. There were significantly additive and multiplicative interactions between lifestyle and LDL-C/HDL-C with regards to carotid plaques. CONCLUSION: A high LDL-C/HDL-C is associated with a risk of carotid plaques developing in CHD patients. Adhering to a healthy lifestyle has additive beneficial effects on reducing the risk of carotid plaques, especially in relation to the highest LDL-C/HDL-C.
No takes yet. Share an insight, caveat, or question.
Li et al. (2021) conducted a cohort in Coronary heart disease (n=9,426). LDL-C/HDL-C ratio vs. Lower LDL-C/HDL-C ratio was evaluated on Presence of carotid plaques (OR 1.61, 95% CI 1.43-1.84, p=<0.001). Each unit increase in the LDL-C/HDL-C ratio was significantly associated with a 61% increased risk of carotid plaques in patients with coronary heart disease.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: