期刊
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
卷 20, 期 8, 页码 866-872出版社
OXFORD UNIV PRESS
DOI: 10.1093/ehjci/jez091
关键词
coronary atherosclerosis; LDL cholesterol; risk factors
资金
- Basic Science Research Program through the National Research Foundation of Korea - Ministry of Education [2018R1D1A3B07043344]
- National Research Foundation of Korea [2018R1D1A3B07043344] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
Aims Individuals without traditional cardiovascular risk factors (CVRFs) still experience adverse events in clinical practice. This study evaluated the predictors of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Methods and results A total of 1250 (52.8 +/- 6.5 years, 46.9% male) asymptomatic individuals without CVRFs who underwent coronary computed tomographic angiography for a general health examination were analysed. The following were considered as traditional CVRFs: systolic/diastolic blood pressure >= 140/90 mmHg; fasting glucose >= 126 mg/dL; total cholesterol >= 240 mg/dL; low-density lipoprotein cholesterol (LDL-C) >= 160 mg/dL; high-density lipoprotein cholesterol <40 mg/dL; body mass index >= 25.0 kg/m(2); current smoking status; and previous medical history of hypertension, diabetes, and dyslipidaemia. Subclinical atherosclerosis, defined as the presence of any coronary plaque, was present in 20.6% cases; the incidences of non-calcified, calcified, and mixed plaque were 9.6%, 12.6%, and 2.6%, respectively. Multivariate regression analysis showed that LDL-C level [odds ratio (OR): 1.008; 95% confidence interval (CI): 1.001-1.015], together with age (OR: 1.101; 95% CI: 1.075-1.128) and male sex (OR: 5.574; 95% CI: 3.310-9.388), was associated with the presence of subclinical atherosclerosis (All P < 0.05). LDL-C level was significantly associated with an increased risk of calcified plaques rather than non-calcified or mixed plaques. Conclusion LDL-C, even at levels currently considered within normal range, is independently associated with the presence of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Our results suggest that a stricter control of LDL-C levels may be necessary for primary prevention in individuals who are conventionally considered healthy.
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