Study on the Association between Serum Non-High-Density Lipoprotein Cholesterol and Risk of Cardiovascular Disease Mortality

Objective To explore the association between serum Non-High-Density Lipoprotein Cholesterol(non-HDL-C)levels and cardiovascular disease mortality in the general population.Methods Based on a retrospective cohort study design,we utilized electronic health record data from the health information platform of Yuecheng District,Shaoxing City,Zhejiang Province.The study population consists of community residents aged 40 and above who underwent health examinations at healthcare institutions in Yuecheng District from January to December 2019 and had no previous history of cardiovascular disease.Follow-up was conducted until December 31,2023,to collect data on cardiovascular disease mortality.Non-HDL-C was analyzed as both continuous and categorical variables(based on the quartiles).The Cox proportional hazards model was employed to estimate the hazard ratios(HRs)and 95%confidence intervals(95%CIs)for the association of non-HDL-C with risk of cardiovascular disease mortality.Results The study included a total of 39,038 participants,with 19,085 males(48.9%)and 19,953 females(51.1%),and the mean age was 73.64±9.10 years.The median follow-up time was 53.9 months.During the entire follow-up period,a total of 1,227 cardiovascular disease(CVD)mortality events were identified.After adjusting for confounding factors,for every 1 mmol/L increase in non-HDL-C,the risk of CVD mortality in the overall population decreased by 50%(HR=1.50,95%CI:1.24~1.80).When non-HDL-C levels were categorized into quartiles,with Q1 as the reference,the HRs(95%CIs)for Q2 to Q4 were 1.33(1.11~1.58),1.46(1.19~1.79),and 1.65(1.29~2.11),respectively,with all P values<0.05.Conclusion In this retrospective cohort study,non-HDL-C was associated with a higher risk of cardiovascular disease mortality.Non-HDL-C levels can serve as a biological indicator for monitoring the progression of cardiovascular disease and guiding treatment.