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Cholesterol Control for Subclinical Coronary Atherosclerosis in Subjects Without Indication for

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Abstract
Low-risk individuals still experience adverse cardiac events. We sought to evaluate longterm cardiac events and predictors for subclinical coronary atherosclerosis in subjects without indication for statin therapy. We analyzed 3,272 individuals without indication for statin therapy who voluntarily underwent coronary computed tomography angiography as part of a general health examination. A cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, or late coronary revascularization. The prevalence of normal coronary arteries, nonobstructive coronary artery disease (CAD) (diameter stenosis < 50%), and obstructive CAD (diameter stenosis >= 50%) was 2,338 (71.5%), 809 (24.7%), and 125 (3.8%), respectively. During the follow-up period (median 5.3 [interquartile range, 4.3-6.3] years), the 6-year event-free survival rates were 99.2%+/- 0.2% in subjects with normal coronary arteries, 98.2%+/- 0.6% in those with nonobstructive CAD, and 90.2%+/- 2.7% in those with obstructive CAD (log-rank p < 0.001). Multivariable regression analysis showed that low-density lipoprotein cholesterol (LDL-C, odds ratio [OR]: 1.012; 95% confidence interval (CI): 1.005-1.019) and high-density lipoprotein cholesterol (HDL-C, OR: 0.968; 95% CI: 0.952-0.984) levels were associated with subclinical obstructive CAD, together with age (OR: 1.080; 95% CI: 1.040-1.121) and male sex (OR: 3.102; 95% CI: 1.866-5.155) (all p < 0.05). In conclusion, LDL-C and HDL-C are significantly associated with the presence of subclinical obstructive CAD with a worse prognosis in subjects without indication for statin therapy. These findings suggest that stricter control of LDL-C and HDL-C levels may be necessary for primary prevention even in a relatively low-risk population. (c) 2021 Elsevier Inc. All rights reserved. (Am J Cardiol 2021;153:51-57)
Author(s)
강준원김영학김용균김홍규박경민박상우박현우서존양동현이승환이용직조용락최재원
Issued Date
2021
Type
Article
Keyword
Abridged Index Medicus
DOI
10.1016/j.amjcard.2021.05.019
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7075
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2545988387&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Cholesterol%20Control%20for%20Subclinical%20Coronary%20Atherosclerosis%20in%20Subjects%20Without%20Indication%20for&amp;offset=0&amp;pcAvailability=true
Publisher
AMERICAN JOURNAL OF CARDIOLOGY
Location
미국
Language
영어
ISSN
0002-9149
Citation Volume
153
Citation Start Page
51
Citation End Page
57
Appears in Collections:
Medicine > Medicine
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