Association between HDL-C concentration and risk for a major cardiovascular event

Abstract

Objective:

To determine the association between baseline HDL-C concentrations and risk of a major cardiovascular event (within 5 years) in a large US claims database.

Methods:

A retrospective longitudinal analysis using claims data from the i3 Ingenix LabRx database was conducted. Patients were included if they had complete lipid panel lab results, were continuously enrolled for ≥6 months prior to and ≥12 months following the lab test (index date), and were ≥50 years of age. Cox proportional hazards analysis assessed the association between HDL-C concentrations and risk of a major cardiovascular event within 5 years of the index date, after adjusting for covariates.

Results:

There was a statistically significant association between HDL-C and risk of a major cardiovascular event. A 0.026 mmol/L (1 mg/dL) increase in HDL-C from baseline was associated with a 1.3% decreased risk of a major cardiovascular event (e.g., a 0.13 mmol/L [5 mg/dL] increase in HDL-C above baseline concentrations was associated with a 6.5% decrease). This association became evident within 1 year of follow-up.

Conclusions:

HDL-C concentrations were inversely associated with the occurrence of cardiovascular events within 5 years. Women who were ≥0.26 mmol/L (10 mg/dL) below their target concentrations had cardiovascular risk similar to that of women with baseline ischemic heart disease and hypertension, and men who were ≥0.26 mmol/L (10 mg/dL) below their target concentrations had cardiovascular risk similar to that of men with baseline cardiovascular disease, diabetes, or cerebrovascular disease. Limitations inherent to claims-based analyses must be considered when interpreting these findings, such as the potential for miscoding or incomplete data, and the fact that the presence of a diagnosis code on a medical claim is not positive presence of disease. Furthermore, patients who suffered a fatal cardiovascular event at home during the study period, and therefore did not receive treatment, were not captured in this analysis.

Key words::

• Cardiovascular diseases
• Cholesterol
• Coronary heart diseases
• Dyslipidemia
• HDL

Transparency

Declaration of funding

This study was supported by Abbott Laboratories.

Declaration of financial/other relationships

The authors have disclosed that they are employed by Abbott Laboratories, the funder of the study.

Some peer reviewers receive honoraria from CMRO for their review work. The peer reviewers of this paper have disclosed that they have no relevant financial relationships.

Acknowledgment

The authors thank Victoria Porter and Virginia M. Rosen, PhD, of i3 Innovus for their assistance with the preparation of this manuscript.

All authors were involved in the study design and analysis and the preparation of the manuscript.