The impact of accumulated exposure to non-high-density lipoprotein cholesterol on premature cardiovascular events

Background: There are many common risk factors for premature cardiovascular disease. Among them, non-high-density lipoprotein cholesterol (non-HDL-C) has been proven to be a significant risk factor. However, a single measurement cannot reflect the long-term impact of non-HDL-C on premature cardiovascular disease. Methods This study selected active and retired employees from Kailuan Group who participated in the annual health examinations in 2006, 2008, and 2010 as the study population. The Cox proportional hazards regression model was used to analyze the hazard ratios (HR) and 95% confidence intervals (95% CI) of different cumulative exposures to non-HDL-C on the risk of premature cardiovascular disease. Results During a median follow-up period of 9.88 years, we observed 285 cases of early cardiovascular events out of 16,684 study participants. The Cox proportional hazards regression model analysis showed that as the cumulative exposure to non-HDL-C increased, the risk of premature cardiovascular disease gradually increased. Compared to the reference group first quartile of cumnon-HDL-C, the HRs (95% CI) for the second, third, and fourth quartiles were 1.26 (0.81, 1.95), 1.58 (1.04, 2.40), and 1.81 (1.18, 2.77), respectively. Furthermore, with longer cumulative exposure times, the risk of premature cardiovascular disease increased. Compared to no cumulative exposure to non-HDL-C, the HRs (95% CI) for cumulative exposures of 2 years and ≥ 4 years were 1.63 (1.16, 2.30) and 1.73 (1.07, 2.79), respectively. Conclusion Cumulative exposure to non-HDL-C is a risk factor for early cardiovascular events and is independent of single non-HDL-C measurement values.