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@ARTICLE{Hilvo:169060,
      author       = {M. Hilvo and I. Dhar and M. Lääperi and V. Lysne and G.
                      Sulo and G. S. Tell and P. Jousilahti and O. K. Nygård and
                      H. Brenner$^*$ and B. Schöttker$^*$ and R. Laaksonen},
      title        = {{P}rimary cardiovascular risk prediction by
                      {LDL}-cholesterol in {C}aucasian middle-aged and older
                      adults: a joint analysis of three cohorts.},
      journal      = {European journal of preventive cardiology},
      volume       = {29},
      number       = {3},
      issn         = {2047-4881},
      address      = {London [u.a.]},
      publisher    = {Sage Publ.},
      reportid     = {DKFZ-2021-01218},
      pages        = {e128-e137},
      year         = {2022},
      note         = {2022 Mar 25;29(3):e128-e137},
      abstract     = {Low-density lipoprotein cholesterol (LDL-C) is an
                      established causal driver of atherosclerotic cardiovascular
                      disease (ASCVD), but its performance and age-dependency as a
                      biomarker for incident events and mortality arising from
                      ASCVD is less clear. The aim was to determine the value of
                      LDL-C as a susceptibility/risk biomarker for incident
                      coronary heart disease (CHD), ASCVD, and stroke events and
                      deaths, for the age groups <50 and ≥50 years.The
                      performance of LDL-C was evaluated in three cohorts, FINRISK
                      2002 (n = 7709), HUSK (n = 5431), and ESTHER (n = 4559), by
                      Cox proportional hazards models, C-statistics, and net
                      reclassification index calculations. Additionally, the
                      hazard ratios (HRs) for the three cohorts were pooled by
                      meta-analysis. The most consistent association was observed
                      for CHD $[95\%$ confidence interval (CI) for HRs per
                      standard deviation ranging from 0.99 to 1.37], whereas the
                      results were more modest for ASCVD (0.96-1.18) due to lack
                      of association with stroke (0.77-1.24). The association and
                      discriminatory value of LDL-C with all endpoints in FINRISK
                      2002 and HUSK were attenuated in subjects 50 years and older
                      [HRs $(95\%$ CI) obtained from meta-analysis 1.11
                      (1.04-1.18) for CHD, 1.15 (1.02-1.29) for CHD death, 1.02
                      (0.98-1.06) for ASCVD, 1.12 (1.02-1.23) for ASCVD death, and
                      0.97 (0.89-1.05) for stroke].In middle-aged and older
                      adults, associations between LDL-C and all the studied
                      cardiovascular endpoints were relatively weak, while LDL-C
                      showed stronger association with rare events of pre-mature
                      CHD or ASCVD death among middle-aged adults. The predictive
                      performance of LDL-C also depends on the studied
                      cardiovascular endpoint.},
      keywords     = {Cholesterol (Other) / Guideline (Other) / LDL (Other) /
                      Performance (Other) / Prediction (Other) / Risk (Other)},
      cin          = {C070},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34060615},
      doi          = {10.1093/eurjpc/zwab075},
      url          = {https://inrepo02.dkfz.de/record/169060},
}