Short term prediction of cardiovascular outcomes in adults over 30 years by serum lipid markers
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Background: To evaluate the role of lipid markers including total cholesterol (TC), LDL-C and HDL-C vs. lipid indices (TC/HDL-C, LDL-C/HDL-C and non-HDL-C) as short term predictors of cardiovascular outcomes in adults over 30 years. Methods: As a nested case and control study, there were 207 CVD events among participants of Tehran Lipid and Glucose Study (TLGS) documented during 3 years of follow-up. Those cases that were free of CVD at baseline (132 subjects) were matched to 264 controls for age and sex. In all subjects, demographic and clinical data including blood pressure and anthropometric measurements as well as serum lipids, fasting and 2-hour glucose were available from the database of the TLGS. We estimated the relative risk (RR) for each lipid parameter in a multiple stepwise regression model after adjustment for family history of premature CHD, smoking, systolic and diastolic blood pressure, fasting and 2-hour plasma glucose and waist-to-hip ratio. Results: The RRs associated with an increase of ?1 SD of independent lipid predictors in the multivariate model were as follow: total cholesterol (RR=1.6 [1.2-2.0], SD= 1.3 mmol/L), LDL-C (RR=1.5 [1.1-2.0], SD= 1 mmol/L), non-HDL-C (RR=1.6 [1.2-2.1], SD= 1.2 mmol/L) and cholesterol/HDL-C (RR= 1.5 [1.1-2.0], SD= 1.8). The comparing of these four independent variables with ROC curve analysis showed that there was no significant difference in their predictive power for cardiovascular outcome. There was no association between HDL-C, triglyceride and LDL-C/HDL-C and CVD outcome in multivariate analysis. Conclusion: This study showed that TC, LDL-C, non-HDL-C and TC/HDL-C have similar predictive values for short term prediction of CVD outcome. It seems TC may be a reasonable choice for short term prediction of CVD outcome, because of lower cost.
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