ArticleJournal of the American Heart Association2023
Variability in Lipid Levels and Risk for Cardiovascular Disease: An Electronic Health Record-Based Population Cohort Study.
Article in Journal of the American Heart Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Lipid variability and risk of microvascular complications in patients with diabetes: a systematic review and meta-analysis.BMC endocrine disorders · 2024Pooled it
- Association of Year-to-Year Lipid Variability With Risk of Cognitive Decline and Dementia in Community-Dwelling Older Adults.Neurology · 2025Trial
- Inclisiran Response in a Patient With Familial Hypercholesterolemia After Suboptimal Response to Evolocumab.JACC. Case reports · 2026Article
- Combined Impact of Mean and Variability of Non-HDL Cholesterol on Myocardial Infarction in Hemodialysis Patients.Journal of clinical medicine · 2025Article
- Identification of plasma phosphatidylethanolamine species associated with myocardial infarction risk in patients with stable angina: A cross-sectional lipidomics study.The Journal of international medical research · 2025Article
- Small dense LDL: An underestimated driver of atherosclerosis (Review).Molecular medicine reports · 2025Review
- Review
- Spatial heterogeneity and its influencing factors of cardiometabolic multimorbidity in a natural community population: a study based on Lingwu city, rural Northwest China.BMC public health · 2025Article
- Visit-to-visit lipid variability, coronary artery calcification, inflammation, and mortality in the Multi-Ethnic Study of Atherosclerosis.European journal of preventive cardiology · 2025Observational
- Critical Appraisal of Remnant Cholesterol as a Predictor of Cardiovascular Risk in Hypertensive Patients.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Punicic Acid: A Potential Nutraceutical Compound in Pomegranate Seed Oil and Its Cardiovascular Benefits.Foods (Basel, Switzerland) · 2025Article
- Visit-to-Visit Variability in Lipid Levels and Risk of Incident Heart Failure in Adults With Type 2 Diabetes.Diabetes care · 2025Article
- Fasting Glucose, Haemoglobin A1C (HbA1c), Blood Lipid, and Triglyceride-Glucose Index Parameters in Relation to Subjective Tinnitus.Biomedicines · 2025Article
- Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry.Scientific reports · 2025Article
- Liver function differences in atherosclerotic cardiovascular disease: a multi-ethnic dual-cohort retrospective study.Frontiers in endocrinology · 2025Article
- Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study.Journal of nutrition and metabolism · 2025Article
- L-shaped association of plasma low-density lipoprotein cholesterol with atrial fibrillation recurrence after catheter ablation: a prospective cohort study.Scientific reports · 2024Article
- Article
- Lipid Swings Provoke Vascular Inflammation.Endocrinology and metabolism (Seoul, Korea) · 2024Article
- Effects of metabolic parameters' variability on cardiovascular outcomes in diabetic patients.Cardiovascular diabetology · 2023Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
Background Larger within-patient variability of lipid levels has been associated with increased risk of cardiovascular disease (CVD); however, measures of lipid variability require ≥3 measurements and are not currently used clinically. We investigated the feasibility of calculating lipid variability within a large electronic health record-based population cohort and assessed associations with incident CVD. Methods and Results We identified all individuals ≥40 years of age who resided in Olmsted County, MN, on January 1, 2006 (index date), without prior CVD, defined as myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention, or CVD death. Patients with ≥3 measurements of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglycerides during the 5 years before the index date were retained. Lipid variability was calculated using variability independent of the mean. Patients were followed through December 31, 2020 for incident CVD. We identified 19 652 individuals (mean age 61 years; 55% female), who were CVD-free and had variability independent of the mean calculated for at least 1 lipid type. After adjustment, those with highest total cholesterol variability had a 20% increased risk of CVD (Q5 versus Q1 hazard ratio, 1.20 [95% CI, 1.06-1.37]). Results were similar for low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Conclusions In a large electronic health record-based population cohort, high variability in total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol was associated with an increased risk of CVD, independent of traditional risk factors, suggesting it may be a possible risk marker and target for intervention. Lipid variability can be calculated in the electronic health record environment, but more research is needed to determine its clinical utility.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.