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Prognostic Implication of LDL-C Variability and Its Association with Lipid-Lowering Strategies: Insights from the RACING and LODESTAR Trials

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dc.contributor.author고영국-
dc.contributor.author김병극-
dc.contributor.author김중선-
dc.contributor.author안철민-
dc.contributor.author이상협-
dc.contributor.author이승준-
dc.contributor.author장양수-
dc.contributor.author최동훈-
dc.contributor.author홍명기-
dc.contributor.author홍범기-
dc.contributor.author홍성진-
dc.date.accessioned2025-10-15T01:53:23Z-
dc.date.available2025-10-15T01:53:23Z-
dc.date.issued2025-09-
dc.identifier.issn0513-5796-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/207505-
dc.description.abstractLipid-lowering therapy ; atherosclerotic cardiovascular disease ; cardiovascular outcome ; low-density lipoprotein cholesterol-
dc.description.statementOfResponsibilityT202506166.pdf-
dc.languageEnglish-
dc.publisherYonsei University-
dc.relation.isPartOfYONSEI MEDICAL JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESH0-
dc.titlePrognostic Implication of LDL-C Variability and Its Association with Lipid-Lowering Strategies: Insights from the RACING and LODESTAR Trials-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorJaeoh Lee-
dc.contributor.googleauthorSripal Bangalore-
dc.contributor.googleauthorKyeong Ho Yun-
dc.contributor.googleauthorSang-Hyup Lee-
dc.contributor.googleauthorYong-Joon Lee-
dc.contributor.googleauthorSeung-Jun Lee-
dc.contributor.googleauthorSung-Jin Hong-
dc.contributor.googleauthorChul-Min Ahn-
dc.contributor.googleauthorJung-Sun Kim-
dc.contributor.googleauthorByeong-Keuk Kim-
dc.contributor.googleauthorYoung-Guk Ko-
dc.contributor.googleauthorDonghoon Choi-
dc.contributor.googleauthorYangsoo Jang-
dc.contributor.googleauthorBum-Kee Hong-
dc.contributor.googleauthorMyeong-Ki Hong-
dc.identifier.doiPurpose: We aimed to compare the visit-to-visit variability in low-density lipoprotein cholesterol (LDL-C) according to different lipid-lowering strategies and evaluate its prognostic implications using data from previous trials. Materials and methods: We analyzed two randomized clinical trials: the RACING trial and the LODESTAR trial. LDL-C variability was evaluated using standard deviation (SD), coefficient of variation, and variation independent of mean. The primary endpoint was a composite of death, myocardial infarction, stroke, or coronary revascularization. Results: Among the 6800 patients included, when compared with patients randomized to high-intensity statins, LDL-C variability was similar in the group randomized to moderate-intensity statin plus ezetimibe combination, but it was higher in those randomized to treat-to-target strategy. The variability in LDL-C (by SD) was a predictor of primary endpoint even after adjustment for lipid-lowering strategy and mean LDL-C (hazard ratio 1.024; 95% confidence interval 1.014 to 1.035; p<0.001). Every 1-SD increase in LDL-C variability (SD) was also independently associated with higher risk of myocardial infarction by 2.1%, stroke by 3.5%, and coronary revascularization by 2.7%. Conclusion: Compared to high-intensity statin therapy, LDL-C variability was not increased with the moderate-intensity statin plus ezetimibe combination therapy; however, it was increased in the treat-to-target strategy. Even among those treated with moderate- or high-intensity statins or statins with a target LDL-C levels of 50-70 mg/dL, increased LDL-C variability was associated with higher risk of adverse cardiovascular outcomes.-
dc.contributor.localIdA00127-
dc.contributor.localIdA00493-
dc.contributor.localIdA00961-
dc.contributor.localIdA02269-
dc.contributor.localIdA06152-
dc.contributor.localIdA02927-
dc.contributor.localIdA03448-
dc.contributor.localIdA04053-
dc.contributor.localIdA04391-
dc.contributor.localIdA04394-
dc.contributor.localIdA04403-
dc.relation.journalcodeJ02813-
dc.identifier.eissn1976-2437-
dc.identifier.pmid40873140-
dc.subject.keywordAged-
dc.subject.keywordAnticholesteremic Agents / therapeutic use-
dc.subject.keywordCholesterol, LDL* / blood-
dc.subject.keywordEzetimibe / therapeutic use-
dc.subject.keywordFemale-
dc.subject.keywordHumans-
dc.subject.keywordHydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use-
dc.subject.keywordMale-
dc.subject.keywordMiddle Aged-
dc.subject.keywordMyocardial Infarction / blood-
dc.subject.keywordPrognosis-
dc.subject.keywordRandomized Controlled Trials as Topic-
dc.subject.keywordStroke-
dc.contributor.alternativeNameKo, Young Guk-
dc.contributor.affiliatedAuthor고영국-
dc.contributor.affiliatedAuthor김병극-
dc.contributor.affiliatedAuthor김중선-
dc.contributor.affiliatedAuthor안철민-
dc.contributor.affiliatedAuthor이상협-
dc.contributor.affiliatedAuthor이승준-
dc.contributor.affiliatedAuthor장양수-
dc.contributor.affiliatedAuthor최동훈-
dc.contributor.affiliatedAuthor홍명기-
dc.contributor.affiliatedAuthor홍범기-
dc.contributor.affiliatedAuthor홍성진-
dc.citation.volume66-
dc.citation.number9-
dc.citation.startPage537-
dc.citation.endPage544-
dc.identifier.bibliographicCitationYONSEI MEDICAL JOURNAL, Vol.66(9) : 537-544, 2025-09-
dc.identifier.articleno10.3349/ymj.2024.0476-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
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