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Title: Is High Serum LDL/HDL Cholesterol Ratio an Emerging Risk Factor for Sudden Cardiac Death? Findings from the KIHD Study
Authors: Kunutsor, Setor K.
Zaccardi, Francesco
Karppi, Jouni
Kurl, Sudhir
Laukkanen, Jari A.
First Published: 26-Oct-2016
Publisher: Japan Atherosclerosis Society
Citation: Journal of Atherosclerosis and Thrombosis, 2017, 24 (6), pp. 600-608
Abstract: Aim: Low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c), which are components of total cholesterol, have each been suggested to be linked to the risk of sudden cardiac death (SCD). However, the relationship between LDL-c/HDL-c ratio and the risk of SCD has not been previously investigated. We aimed to assess the associations of LDL-c, HDL-c, and the ratio of LDL-c/HDL-c with the risk of SCD. Methods: Serum lipoprotein concentrations were assessed at baseline in the Finnish Kuopio Ischemic Heart Disease prospective cohort study of 2,616 men aged 42–61 years at recruitment. Hazard ratios (HRs) (95% confidence intervals [CI]) were assessed. Results: During a median follow-up of 23.0 years, a total of 228 SCDs occurred. There was no significant evidence of an association of LDL-c or HDL-c with the risk of SCD. In analyses adjusted for age, examination year, body mass index, systolic blood pressure, smoking, alcohol consumption, physical activity, years of education, diabetes, previous myocardial infarction, family history of coronary heart disease, and serum high sensitivity C-reactive protein, there was approximately a two-fold increase in the risk of SCD (HR 1.94, 95% CI 1.21–3.11; p=0.006), comparing the top (>4.22) versus bottom (≤2.30) quintile of serum LDL-c/HDL-c ratio. Conclusion: In this middle-aged male population, LDL-c or HDL-c was not associated with the risk of SCD. However, a high serum LDL-c/HDL-c ratio was found to be independently associated with an increased risk of SCD. Further research is warranted to understand the mechanistic pathways underlying this association.
DOI Link: 10.5551/jat.37184
ISSN: 1340-3478
eISSN: 1880-3873
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2016. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-ShareAlike License ( ), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and provided the original author and source are credited, and that any contributions are distributed under the same license as the original.
Appears in Collections:Published Articles, College of Medicine, Biological Sciences and Psychology

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