Introduction and Objective: The power of cardiovascular risk prediction is biased by comorbidities (e.g. metabolic syndrome, MetS), medical treatment, and age, which impact cholesterol levels. When applying LDL-C, the true risk of such confounded patients is often underestimated. However, it is unclear whether this likewise applies to other lipid markers, in particular ceramides.Methods: In this prospective cohort study, we recorded cardiovascular mortality for 16 years in 1306 patients. Their median age was 67 years, all had a high preexisting cardiovascular risk, 53% were taking statins, and 44% had the MetS.Results: Ceramide levels, CERT1 and CERT2 scores but not LDL-C differed significantly between patients with and without MetS. A Cox regression analysis adjusting for age, sex, history of smoking, hypertension, BMI and statin use revealed that LDL-C failed to predict cardiovascular mortality in patients with was well as in patients without the MetS. In contrast, ceramide-based markers were able to significantly predict cardiovascular mortality after stratification and multivariate adjustment in both subgroups.Conclusion: We thus propose that ceramide-based predictors rather than LDL-C should be applied for a more accurate cardiovascular risk prediction in high risk patients with as well as in those without the MetS.
L. Schnetzer: None. A. Leiherer: None. A. Muendlein: None. B. Larcher: None. A. Mader: None. T. Plattner: None. A. Vonbank: None. A. Festa: None. H. Drexel: None. C.H. Saely: None.
Source link
Leave a Reply