In individuals aged 76-92, each 1 mmol/L higher LDL-C increased MI risk by 57% (aHR 1.57) and was linked to greater coronary plaque and revascularization rates.
Does higher LDL-C increase the risk of coronary plaque burden and myocardial infarction in symptomatic statin-naïve individuals aged 76-92?
Elevated LDL-C remains a significant driver of coronary plaque burden and myocardial infarction risk even in symptomatic statin-naïve individuals aged 76-92.
Absolute Event Rate: 0% vs 0%
Abstract Aims The role of low-density lipoprotein cholesterol (LDL-C) in atherosclerotic cardiovascular disease in individuals aged 75 remains controversial. This study aimed to assess whether LDL-C levels are associated with coronary plaque burden and future myocardial infarctions (MI) in individuals across different ages, with focus on those aged 76-92. Methods This contemporary cohort study included symptomatic statin-naïve individuals who underwent coronary computed tomography angiography (CCTA) from 2008-2021, from the Western Denmark Heart Registry. Outcomes included 1) adjusted risk ratio (aRR) for CAC 90th percentile, 2) aRR for post-CCTA revascularization within 90 days of CCTA, indicating advanced atherosclerotic disease, and 3) adjusted hazard ratio (aHR) for MI. Results The study included 37,910 individuals, of whom 1,562 were aged 76-92. A total of 433 individuals experienced MI during a median follow-up time of 5.1 years. Higher LDL-C levels were associated with higher risk of CAC 90th percentile, post-CCTA revascularization, and MI across all age groups. In individuals aged 76-92, the aRRs per 1 mmol/L higher LDL-C for CAC 90th percentile and for post-CCTA revascularization were 1.19 (95% CI: 1.00-1.40) and 1.41 (1.22-1.64); corresponding values at age 61-75 years were 1.07 (1.01-1.14) and 1.32 (1.23-1.41), respectively. At age 76-92 and 61-75 years, the aHRs for MI were 1.57 (1.06-2.32) and 1.22 (1.03-1.44) per 1 mmol/L higher LDL-C. Conclusion In statin-naïve symptomatic individuals aged 76-92, higher LDL-C was associated with CAC 90th percentile, post-CCTA revascularization, and increased risk of MI. These findings suggest that elevated LDL-C is a driver of coronary artery disease throughout life.
Andersen et al. (Fri,) reported a other. In individuals aged 76-92, each 1 mmol/L higher LDL-C increased MI risk by 57% (aHR 1.57) and was linked to greater coronary plaque and revascularization rates.