Abstract P339: 30-Year Absolute Risks for Coronary Heart Disease in Individuals With Very Low LDL-C
Bibliographic record
Abstract
Introduction: It is unclear if individuals with very low mean low-density lipoprotein cholesterol (LDL-C) during midlife experience significant absolute risk (AR) for coronary heart disease (CHD). Hypothesis: Individuals with LDL-C ≤80mg/dL from ages 20-60 years (y) do not develop significant AR for CHD over 30 y of follow-up. Methods: Our objective was to quantify and compare the 30-year AR for fatal or nonfatal CHD from index ages 20-40 y and 40-60 y in participants (ppts) with LDL-C ≤80, 81-130, and >130 mg/dL using data from the Lifetime Risk Pooling Project. We included ppts who were free from lipid lowering medications and CHD at baseline. Mean LDL-C was an average of multiple (2-5) fasting LDL-C measurements within 10 years prior to the baseline age. We used a modified Kaplan Meier analysis, adjusted for competing risks of death, to quantify the 30-year CHD AR by LDL-C strata. Results: 3,781 men and 4,995 women were followed for a combined 110,431 person*years and experienced 778 events. Among all ppts, tobacco use ranged from 20-40% and hypertension prevalence ranged from 13-40%. Non-lipid risk factor profiles were generally more favorable in the low-LDL-C strata. At index ages 20-40, men and women with LDL-C ≤80mg/dL did not experience risk for CHD over 20 and 25 years, respectively (Figure). A similar pattern was seen in the LDL-C 80-130mg/dL strata. At index ages 40-60, men and women with LDL-C ≤80mg/dL experienced no risk for CHD for 5 to 15 years, respectively. However, both sex groups saw a gradual increase in risk up to 13.7% (95% confidence interval [CI] 1.9-25.4%) for men and 5.2% (95% CI 2.0-8.4%) for women at year 30 of follow-up. Conclusion: Young ppts with LDL-C ≤80mg/dL had very low CHD risks across midlife despite significant risk factor burden. At older ages, ppts with low LDL-C develop modest AR for CHD suggesting adverse lipid changes over time or alternative mediators of CHD in this age group.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".