You are here
Cardiovascular Disease, Mortality Risk, and Healthcare Costs by Lipoprotein(a) Levels According to Low-density Lipoprotein Cholesterol Levels in Older High-risk Adults.
Wednesday,2016-08-17 16:23 America/Los_Angeles — zdrager
| Title | Cardiovascular Disease, Mortality Risk, and Healthcare Costs by Lipoprotein(a) Levels According to Low-density Lipoprotein Cholesterol Levels in Older High-risk Adults. |
| Publication Type | Journal Article |
| Year of Publication | 2016 |
| Authors | Zhao, Y, Delaney, JA, Quek, RGW, Gardin, JM, Hirsch, CH, Gandra, SR, Wong, ND |
| Journal | Clin Cardiol |
| Volume | 39 |
| Issue | 7 |
| Pagination | 413-20 |
| Date Published | 2016 Jul |
| ISSN | 1932-8737 |
| Abstract | <p><b>BACKGROUND: </b>The value of lipoprotein(a) (Lp[a]) for predicting cardiovascular disease (CVD) across low-density lipoprotein cholesterol (LDL-C) is uncertain.</p><p><b>HYPOTHESIS: </b>In older high-risk adults, higher LDL and Lp(a) combined would be associated with higher CVD risk and more healthcare costs.</p><p><b>METHODS: </b>We included 3251 high-risk subjects (prior CVD, diabetes, or 10-year Framingham CVD risk >20%) age ≥65 years from the Cardiovascular Health Study and examined the relation of Lp(a) tertiles with incident CVD, coronary heart disease (CHD), and all-cause mortality within LDL-C strata (spanning <70 mg/dL to ≥160 mg/dL). We also examined 1-year all-cause and CVD healthcare costs from Medicare claims.</p><p><b>RESULTS: </b>Over a 22.5-year follow-up, higher Lp(a) levels predicted CVD and total mortality (both standardized hazard ratio [HR]: 1.06, P < 0.01), whereas higher LDL-C levels predicted higher CHD (standardized HR: 1.09, P < 0.01) but lower total mortality (standardized HR: 0.94, P < 0.001). Adjusted HRs in the highest (vs lowest) tertile of Lp(a) level were 1.95 (P = 0.06) for CVD events and 2.68 (P = 0.03) for CHD events when LDL-C was <70 mg/dL. One-year all-cause healthcare costs were increased for Lp(a) ($771 per SD of 56 µg/mL [P = 0.03], $1976 for Lp(a) 25-64 µg/mL vs <25 µg/mL [P = 0.02], and $1648 for Lp(a) ≥65 µg/mL vs <25 µg/mL [P = 0.054]) but not LDL-C.</p><p><b>CONCLUSIONS: </b>In older high-risk adults, increased Lp(a) levels were associated with higher CVD risk, especially in those with LDL-C <70 mg/dL, and with higher healthcare costs.</p> |
| DOI | 10.1002/clc.22546 |
| Alternate Journal | Clin Cardiol |
| PubMed ID | 27177347 |