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024 7 _ |a 10.1093/eurjpc/zwab075
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024 7 _ |a 2047-4873
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024 7 _ |a 2047-4881
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037 _ _ |a DKFZ-2021-01218
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Hilvo, Mika
|0 0000-0003-0663-5843
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245 _ _ |a Primary cardiovascular risk prediction by LDL-cholesterol in Caucasian middle-aged and older adults: a joint analysis of three cohorts.
260 _ _ |a London [u.a.]
|c 2022
|b Sage Publ.
336 7 _ |a article
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500 _ _ |a 2022 Mar 25;29(3):e128-e137
520 _ _ |a 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.
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650 _ 7 |a Cholesterol
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650 _ 7 |a Guideline
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650 _ 7 |a LDL
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650 _ 7 |a Performance
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650 _ 7 |a Prediction
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650 _ 7 |a Risk
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700 1 _ |a Dhar, Indu
|0 0000-0002-3096-8165
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700 1 _ |a Lääperi, Mitja
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700 1 _ |a Lysne, Vegard
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700 1 _ |a Sulo, Gehard
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700 1 _ |a Tell, Grethe S
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700 1 _ |a Jousilahti, Pekka
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700 1 _ |a Nygård, Ottar K
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700 1 _ |a Brenner, Hermann
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700 1 _ |a Schöttker, Ben
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700 1 _ |a Laaksonen, Reijo
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