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Association of changes in lipids with risk of myocardial infarction among people without lipid-lowering therapy

  • Author Footnotes
    1 These authors contributed equally to this work.
    Xue Tian
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Yingting Zuo
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
    Search for articles by this author
  • Shuohua Chen
    Affiliations
    Department of Cardiology, Kailuan Hospital, North China University of Science and Technology,Tangshan, China
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  • Haibin Li
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
    Search for articles by this author
  • Yan He
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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  • Licheng Zhang
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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  • Ji An
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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  • Shouling Wu
    Correspondence
    Corresponding author. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Rd,Tangshan, 063000,China.
    Affiliations
    Department of Cardiology, Kailuan Hospital, North China University of Science and Technology,Tangshan, China
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  • Yanxia Luo
    Correspondence
    Corresponding author. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 10069,China.
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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  • Anxin Wang
    Correspondence
    Corresponding author. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing 100070, China.
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • Author Footnotes
    1 These authors contributed equally to this work.

      Highlights

      • Changes in lipids would increase the predictive value of conventional risk factors.
      • Changes in lipids except triglyceride are related to myocardial infarction risk.
      • Early detection and control of lipids is also beneficial for young people.

      Abstract

      Background and aims

      Although serum lipids are widely accepted as independent predictors of myocardial infarction (MI), there is insufficient evidence for associations of changes in lipid levels with MI. The present study aimed at investigating the associations between changes in lipids and incidence of MI in people without lipid-lowering therapy.

      Methods

      64,031 Chinese participants (mean age: 53.42 ± 11.95 years) without previous MI were enrolled in the study. The participants were divided into four categories based on quartiles of lipid changes. Multivariable Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for MI.

      Results

      During a median follow-up of 7.03 years, 599 individuals developed MI. After adjustment for covariates, increased total cholesterol (TC), increased low-density lipoprotein cholesterol (LDL-C), increased non-high-density lipoprotein cholesterol (non-HDL-C), and decreased high-density lipoprotein cholesterol (HDL-C) were associated with elevated risk of MI, with HRs (95% CIs) in the highest quartile group compared with the lowest quartile group of 1.56 (1.21–2.01), 1.96 (1.49–2.57), 1.95 (1.52–2.50), and 0.69 (0.53–0.90), respectively. However, changes in triglyceride (TG) were not associated with MI risk (p = 0.8030).

      Conclusions

      Changes in levels of TC, LDL-C, non-HDL-C, and HDL-C, but not TG, were associated with risk of MI. Early detection and control of lipid levels may be beneficial and necessary for young people and those with healthy lipid levels at baseline.

      Graphical abstract

      Keywords

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