ArticleCirculation2023
Low-Density Lipoprotein Cholesterol Is Predominantly Associated With Atherosclerotic Cardiovascular Disease Events in Patients With Evidence of Coronary Atherosclerosis: The Western Denmark Heart Registry.
Article in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 4 of them syntheses that pooled it.
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Who cites it
76 citing papers in PubMed, 4 syntheses or guidelines pooled it, 134 citations in OpenAlex.
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- Distinct Laboratory and Clinical Features of Metabolic and Alcohol-Related Liver Disease (MetALD): A Systematic Review and Meta-Analysis.Current obesity reports · 2026Pooled it
- National Heart Center/Saudi Heart Association 2025 Guidelines for Cardiovascular Diseases Prevention and Risk Assessment.Saudi medical journal · 2026Guideline
- Hypocaloric low-carbohydrate versus low-fat diets on flow-mediated dilation, blood pressure, cardiovascular biomarkers, and body composition in individuals with overweight or obesity: a systematic review and meta-analysis of randomized clinical trials.European journal of clinical nutrition · 2025Pooled it
- Trial
- Factors associated with adverse cardiovascular events after coronary artery bypass grafting and their relationship with left atrial function: a retrospective cohort study.Journal of thoracic disease · 2026Article
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- Metagenomic next-generation sequencing of cerebrospinal fluid reveals pathogen spectrum and mortality predictors among patients with advanced HIV-1 disease at a tertiary hospital in China.Virology journal · 2026Article
- Coronary artery calcification in Type 2 diabetes mellitus: biochemical and inflammatory insights from the Pakistani Population - a case-control study.BMC endocrine disorders · 2026Article
- Coagulation protease-activated receptor-2 (PAR2) promotes dyslipidemia, obesity and MASLD through repression of the hepatic pioneer factor HNF4α.JHEP reports : innovation in hepatology · 2026Article
- LDL-C combined with Chinese visceral adiposity index as a risk stratification tool for cardiometabolic multimorbidity in middle-aged and older Chinese adults: a national prospective cohort study.Cardiovascular diabetology · 2026Article
- Coronary plaque burden as a determinant of cardiovascular outcomes in patients undergoing percutaneous coronary intervention versus coronary artery bypass grafting: The Western Denmark Heart Registry.American journal of preventive cardiology · 2026Article
- A latent class analysis of cardiometabolic risk factors and the predicted prevalence of subclinical atherosclerosis in middle-aged Swedish adults.Scientific reports · 2026Article
- Coronary CT angiography evaluation with artificial intelligence for individualized medical treatment of atherosclerosis: a Consensus Statement from the QCI Study Group.Nature reviews. Cardiology · 2026Review
- Preoperative LDL-C and mortality after cardiac valve surgery: a retrospective cohort study on the mediating role of inflammatory risk.Lipids in health and disease · 2026Article
- Latent profile analysis of health status and influencing factors among patients with coronary heart disease based on patient-reported outcomes.Frontiers in cardiovascular medicine · 2026Article
- LDL-C Estimation in Ghana: A Comparative Study of 13 Calculation Methods.BioMed research international · 2026Article
- RNA-Targeted Therapeutics for Lipid Metabolic Disorders: From Bench to Bedside.Research (Washington, D.C.) · 2026Article
- Differential age-related patterns in the associations of LDL-C, TG/HDL-C ratio, and carotid plaque: a large-scale cross-sectional study in a Chinese health check-up population.Frontiers in cardiovascular medicine · 2026Article
- Per- and polyfluoroalkyl substances (PFAS) exposure and cardiovascular risk: lipid profile as a mediator.Lipids in health and disease · 2025Article
16 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundLow-density lipoprotein cholesterol (LDL-C) is an important causal risk factor for atherosclerotic cardiovascular disease (ASCVD). However, a sizable proportion of middle-aged individuals with elevated LDL-C level have not developed coronary atherosclerosis as assessed by coronary artery calcification (CAC). Whether presence of CAC modifies the association of LDL-C with ASCVD risk is unknown. We evaluated the association of LDL-C with future ASCVD events in patients with and without CAC.
methodsThe study included 23 132 consecutive symptomatic patients evaluated for coronary artery disease using coronary computed tomography angiography (CTA) from the Western Denmark Heart Registry, a seminational, multicenter-based registry with longitudinal registration of patient and procedure data. We assessed the association of LDL-C level obtained before CTA with ASCVD (myocardial infarction and ischemic stroke) events occurring during follow-up stratified by CAC>0 versus CAC=0 using Cox regression models adjusted for baseline characteristics. Outcomes were identified through linkage among national registries covering all hospitals in Denmark. We replicated our results in the
resultsDuring a median follow-up of 4.3 years, 552 patients experienced a first ASCVD event. In the overall population, LDL-C (per 38.7 mg/dL increase) was associated with ASCVD events occurring during follow-up (adjusted hazard ratio [aHR], 1.14 [95% CI, 1.04-1.24]). When stratified by the presence or absence of baseline CAC, LDL-C was only associated with ASCVD in the 10 792/23 132 patients (47%) with CAC>0 (aHR, 1.18 [95% CI, 1.06-1.31]); no association was observed among the 12 340/23 132 patients (53%) with CAC=0 (aHR, 1.02 [95% CI, 0.87-1.18]). Similarly, a very high LDL-C level (
conclusionsLDL-C appears to be almost exclusively associated with ASCVD events over ≈5 years of follow-up in middle-aged individuals with versus without evidence of coronary atherosclerosis. This information is valuable for individualized risk assessment among middle-aged people with or without coronary atherosclerosis.
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