The independent correlation between high-density lipoprotein XXXX and subsequent major adverse coronary events.

@entity1 @entity1187 @entity101 @entity6 @entity301 @entity1674 @entity583 @entity165
BACKGROUND: There is substantial evidence from clinical trials that lowering low-density lipoprotein @entity165 (LDL-C) reduces cardiovascular risk. There is less evidence for the salutatory effects of raising high-density lipoprotein @entity165 (HDL-C). The predictive strength of an initial HDL-C measurement and its change over time for major adverse coronary events is not well understood. METHODS: We identified a cohort of all 6928 @entity1 in an urban primary care practice who had two or more lipid measurements between January 1985 and December 1997. We used bivariable and multivariable (Cox proportional hazards) techniques to identify independent predictors of subsequent major adverse coronary events (hospitalization for @entity583 or @entity1187 ) after the second set of lipid measurements. RESULTS: The time between first and second lipid measurements averaged 2.6 years. During a mean of 5.1 +/- 3.2 years of observation after their second lipid measurements, 2167 (31%) @entity1 had an acute coronary event. @entity1 having events were significantly older, more often white, male, and smokers and more often had antecedent @entity6 , @entity101 , @entity301 , and @entity583 . Adjusting for covariates, a 10-mg/dL higher initial HDL-C was associated with an 11% (95% CI 7%-14%) lower risk of coronary events. A 10-mg/dL increase in HDL-C between lipid measurements was associated with a 7% (95% CI 3%-10%) lower risk of events. Neither initial or change in @entity1674 nor LDL-C predicted subsequent coronary events. CONCLUSION: High-density lipoprotein @entity165 measurements and change in HDL-C predicted major adverse coronary events in this urban practice, which provides support studying interventions targeting HDL-C for cardiovascular risk reduction.
