LDL-C Above 160 mg/dL Associated with Increased MACE Risk in Younger Patients

Data from a recent study led by investigators at Intermountain Healthcare suggests patients with an LDL-C from 160-189 mg/dL were at a greater risk of major adverse cardiovascular events (MACE) in the next 10 years than their counterparts with an LDL-C below 160 mg/dL.

Although results did not reach statistical significance, results of the trial underline the importance of management of patients with slightly elevated LDL-C and provide insight into the risk of cardiovascular outcomes among these patients.

Presented at the American Heart Association (AHA) 2021 Scientific Sessions by Viet Le, PA-C, a physician assistant at Intermountain Healthcare and president of the Association of Physician Assistants in Cardiology, the analysis was conducted to assess the risk of MACE associated with elevated LDL-C in younger patients. To do so, investigators designed the analysis to included patients aged 20-39 years with at least 3 lipid labs and outpatient primary care encounters from January 2020-December 2020.

After the identification of a cohort of 14,570, investigators followed this group for MACE through June 2021. Patients were categorized based on LDL-C, with groups defined as 160-189 mg/dL and less than 160 mg/dL. For the purpose of analysis, components of MACE included all-cause death, myocardial infarction, ischemic stroke, heart failure hospitalization, and peripheral vascular disease. Multivariable logistic regression was used to assess the role of LDL-C as a predictor of MACE.

Upon analysis, results of the investigators’ analysis indicated the risk of MACE among those in the elevated LDL-C group were at a greater risk of experiencing a MACE event, but this failed to reach statistical significance (OR, 1.28 [95% CI, 0.94-1.74]; P <.115).

For more into the results of this study and its implications for clinical practice, Practical Cardiology reached out to Le for his perspective on the data and that conversation is the subject of the following AHA 2021 House Call.

This study, “Analysis of 10-yr MACE Risk of LDL-C ≥160-189 Mg/dL Compared to <160 Mg/dL in Young Adults (ages 20-39) in an Integrated Healthcare System,” was presented at AHA 2021.