دورية أكاديمية

Cardiovascular Disease, Mortality Risk, and Healthcare Costs by Lipoprotein(a) Levels According to Low‐density Lipoprotein Cholesterol Levels in Older High‐risk Adults

التفاصيل البيبلوغرافية
العنوان: Cardiovascular Disease, Mortality Risk, and Healthcare Costs by Lipoprotein(a) Levels According to Low‐density Lipoprotein Cholesterol Levels in Older High‐risk Adults
المؤلفون: Zhao, Yanglu, Delaney, Joseph A, Quek, Ruben GW, Gardin, Julius M, Hirsch, Calvin H, Gandra, Shravanthi R, Wong, Nathan D
المصدر: Clinical Cardiology, vol 39, iss 7
بيانات النشر: eScholarship, University of California
سنة النشر: 2016
المجموعة: University of California: eScholarship
مصطلحات موضوعية: Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Cardiovascular, Aging, Atherosclerosis, Heart Disease, Heart Disease - Coronary Heart Disease, Good Health and Well Being, Age Factors, Aged, 80 and over, Biomarkers, Cardiovascular Diseases, Cholesterol, LDL, Female, Health Care Costs, Humans, Lipoprotein(a), Male, Predictive Value of Tests, Risk Assessment, Risk Factors, Survival Rate, United States, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
جغرافية الموضوع: 413 - 420
الوصف: BackgroundThe value of lipoprotein(a) (Lp[a]) for predicting cardiovascular disease (CVD) across low-density lipoprotein cholesterol (LDL-C) is uncertain.HypothesisIn older high-risk adults, higher LDL and Lp(a) combined would be associated with higher CVD risk and more healthcare costs.MethodsWe 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.ResultsOver 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.ConclusionsIn 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.
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: unknown
العلاقة: qt12w238q7; https://escholarship.org/uc/item/12w238q7Test
الإتاحة: https://escholarship.org/uc/item/12w238q7Test
حقوق: public
رقم الانضمام: edsbas.DFD4593B
قاعدة البيانات: BASE