Dutch Lipid Clinic Network low-density lipoprotein XXXX criteria are associated with long-term mortality in the general population.

@entity24180 @entity286 @entity1 @entity101 @entity6 @entity6817 @entity74 @entity204 @entity65 @entity165
BACKGROUND: @entity24180 ( @entity24180 ) is a severe @entity74 that is underdiagnosed, inadequately treated and has a severe long-term cardiovascular risk. Few studies have evaluated the long-term risk of high low-density lipoprotein @entity165 (LDL-C) concentrations. AIM: To evaluate long-term mortality in a large cohort of healthy subjects, according to LDL-C concentrations. METHODS: Based on a sample of 6956  subjects visiting a preventive cardiology department, we selected adult subjects without a personal history of @entity65 . From 1995 to 2011, 4930  healthy subjects were examined and followed up until 31 December 2011. All-cause deaths were collected exhaustively. A Cox-based multivariable analysis evaluated long-term total mortality risk according to Dutch Lipid Clinic Network (DLCN) LDL-C concentrations. RESULTS: After a mean follow-up of 8.6  years, 123 all-cause deaths were recorded (cumulative mortality rate, 2.5%). In the final multivariable model, major risk factors such as age, sex, @entity286 use and @entity6 were significantly associated with mortality. After adjustment for age, sex, @entity286 use, @entity101 , @entity6 and statin therapy, and in comparison with subjects with LDL-C<4mmol/L (<155mg/dL), subjects with LDL-C between 4 and <5mmol/L (155 to <190mg/dL) had a hazard ratio (HR) of 1.99 (95% confidence interval [CI] 1.31-3.02; P=0.001), subjects with LDL-C between 5 and <6.5mmol/L (190 to <250mg/dL) had an HR of 1.81 (95%  CI, 1.06-3.02; P=0.030), subjects with LDL-C between 6.5 and<8.5mmol/L (250 to <330mg/dL) had an HR of 2.69 (95%  CI, 1.06-6.88; P=0.038) and subjects with LDL-C>= 8.5mmol/L (>= 330mg/dL) had an HR of 6.27 (95%  CI, 0.84-46.57; P=0.073). After excluding @entity1 on @entity6817 at baseline, subjects with LDL-C>= 8.5mmol/L (>= 330mg/dL) had an HR of 8.17 (95%  CI, 1.08-62.73; P=0.042). CONCLUSIONS: The severity of LDL-C elevation is associated with a higher risk of @entity204 in healthy subjects. DLCN LDL-C concentrations may be used in daily practice to identify @entity1 with @entity24180 who warrant aggressive treatment.
