Cumulative Low Density Lipoprotein Cholesterol And Risk Of Acute Myocardial Infarction

Objective To explore the effect of cumulative exposure to Low-density Lipoprotein Cholesterol(LDL-C)on Acute Myocardial Infarction(AMI).Methods Subjects with complete LDL-C measurement data and no history of AMI,stroke,heart failure or cancer were selected for observation using prospective cohort study methods.AMI events were obtained by investigating Kailuan social security information system.SAS9.4 statistical software was used for analysis.Participants were grouped according to the different years of cumulative exposure to elevated LDL-C(cum LDL-C)calculated by the repeated LDL-C measured values.Log-rank test was performed to compare cumulative incidence of AMI in different cum LDL-C groups during the follow-up period.Multivariate Cox regression analysis was conducted to explore the effect of cum LDL-C on AMI.The sensitivity analysis was performed after deleting the participants taking lipid-lowering drugs,antihypertensive drugs and hypoglycemic drugs.Results 51407 participants were included in this study,with an average age of(52.70±11.92)years.The cumulative incidence of AMI in each group was 0.73%,1.12%,1.50%,2.10%,respectively(?2=36.87,P<0.01).After adjusting confounding factors,multivariate Cox regression analysis showed that compared with the participants in cumulative exposure with elevated LDL-C 0 years group,HR(95%CI)of elevated LDL-C 6 years group of AMI was 2.08(1.23~3.51).Compared with the cum LDL-C 1st tertile subgroup,HR(95%CI)of the 3rd tertile group of AMI were 1.39(1.08~1.80).After further adjusting the LDL-C value measured at 2006 health examination,the cumulative exposure to LDL-C was also the risk factor for AMI.Results of the sensitivity analysis were similar as above.Conclusions Prolonged cumulative exposure to LDL-C and high cumulative exposure to LDL-C are risk factors for AMI,independent of single LDL-C measurement.Figure 3;Table 6;Reference 64...