1. Abstract 16263: Association Between Visit-to-Visit Lipid Variability and Cardiovascular Events in Patients With Familial Hypercholesterolemia
- Author
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Na-Qiong Wu, Yuan-Lin Guo, Yan Zhang, Chuan-Que Cui, Yexuan Cao, Jing Sun, Geng Liu, Ying Gao, Rui-Xia Xu, Jian-Jun Li, Cheng-Gang Zhu, Qian Dong, Huihui Liu, Jing-Lu Jin, and Hui-Wen Zhang
- Subjects
medicine.medical_specialty ,Cholesterol ,business.industry ,Familial hypercholesterolemia ,medicine.disease ,chemistry.chemical_compound ,chemistry ,Physiology (medical) ,Internal medicine ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Value (mathematics) - Abstract
Introduction: Visit-to-visit variability in lipid has been suggested as an predictor of major adverse cardiovascular events (MACEs). However, no evidence exists on the prognostic value of lipid variability in patients with familial hypercholesterolemia (FH). Hypothesis: This prospective cohort study aimed to investigate whether lipid variability affects future MACEs in patients with FH receiving standard lipid-lowering therapy. Methods: A total of 254 patients with FH were consecutively enrolled and followed for MACEs. Variability in triglyceride, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) and lipoprotein (a) [Lp(a)] were evaluated from 3 months after discharge using the standard deviation (SD), coefficient of variation (CV) and variability independent of the mean (VIM). Results: During a mean follow-up of 49 months, 22 (8.7%) events occurred. Visit-to-visit variability in Lp(a) was significantly higher in the MACE group compared to the non-MACE group. In multivariate Cox analysis, only Lp(a) variability parameters were independent predictors for MACEs. The hazard ratios and 95% confidence intervals of each 1-SD increase of SD, CV and VIM of Lp(a) were 1.42 (1.12-1.80), 1.50 (1.11-2.02) and 1.60 (1.16-2.22), respectively. Kaplan-Meier analysis revealed that patients with higher Lp(a) variability presented lower event-free survival (Log-rank p Conclusions: This is the first report to evaluate the prognostic value of lipid variability in real-world patients with FH and showed that Lp(a), but not LDL-C variability, was associated with MACEs, which emphasized the importance of regular lipid monitoring in patients with high risk.
- Published
- 2020