Abstract
Background: This study aims to demonstrate the impact of the cumulative burden of low density lipoprotein-cholesterol (cumLDL-c) and high sensitivity C-reactive protein (cumhs-CRP) on cardiovascular risk.Results: During the 4.62 (±0.70) years of follow-up, 2,148 (5.92%) participants had MACE. Both of cumLDL-c and cumhs-CRP were independent risk factors for MACE. In participants without cumLDL-c during 2006-2013, the participants with cumhs-CRP had higher MACE risk during the subsequent 5 years, than those without cumhs-CRP (hazard ratio [HR]: 1.24, 95% confidence interval [CI]:1.04-1.47). In addition, cumhs-CRP correlated with MACE in a cumhs-CRP level-dependent pattern.Conclusion: This study validated the effects of residual inflammation risk in patients with low LDL-c Level in a general population, using long-term burdens of hs-CRP or LDL-c other than a single time-point level.Method: The Kailuan study is a prospective, population-based study began in 2006. These total 36,421 participants completed 4 measurements of hs-CRP and LDL-c biennially from 2006-2013. Cumhs-CRP or cumLDL-c levels were calculated as the number of interval years multiplied by the Δhs-CRP (more than 2.0 mg/L) or ΔLDL-c (more than 2.6 mmol/L). Outcomes measured during follow-up (2012-2017) were defined as major adverse cardiac events (MACE), including ischemic stroke, myocardial infarction, and all-cause mortality.
Highlights
Low density lipoprotein-cholesterol (LDL-c) is an independent risk factor for the development of atherosclerotic cardiovascular disease [1]
A meta-analysis confirmed that both high sensitivity C-reactive protein and LDL-c levels predict vascular risk [9]
It remains unclear whether the cumulative burden of high sensitivity C-reactive protein (hs-CRP) may contribute to the risk of cardiovascular disease (CVD) in the presence of long-term low LDL-c
Summary
Low density lipoprotein-cholesterol (LDL-c) is an independent risk factor for the development of atherosclerotic cardiovascular disease [1]. The CANTOS (Canakinumab antiinflammatory Thrombosis Outcome Study) targeting residual inflammatory risk demonstrated that antiinflammatory therapy significantly reduces the rate of recurrent cardiovascular events independent of decreases in lipid levels [7]. This is in agreement with the pathophysiological viewpoint that atherosclerosis is a disorder involving both hyperlipidemia and inflammation [8]. This study aims to demonstrate the impact of the cumulative burden of low density lipoproteincholesterol (cumLDL-c) and high sensitivity C-reactive protein (cumhs-CRP) on cardiovascular risk. Conclusion: This study validated the effects of residual inflammation risk in patients with low LDL-c Level in a general population, using long-term burdens of hs-CRP or LDL-c other than a single time-point level. Outcomes measured during follow-up (2012-2017) were defined as major adverse cardiac events (MACE), including ischemic stroke, myocardial infarction, and all-cause mortality
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