TY - JOUR
T1 - Low-density lipoprotein cholesterol, coronary plaque burden, and myocardial infarction in adults aged 76-92 years
T2 - The Western Denmark Heart Registry
AU - Andersen, Malene Højgaard
AU - Jensen, Jesper Møller
AU - Kanstrup, Helle
AU - Sand, Niels P Rønnow
AU - Busk, Martin
AU - Hansen, Malene Kærslund
AU - Thrane, Pernille Gro
AU - Olesen, Kevin Kris Warnakula
AU - Nordestgaard, Børge G
AU - Maeng, Michael
AU - Blaha, Michael J
AU - Nørgaard, Bjarne Linde
AU - Mortensen, Martin Bødtker
N1 - © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2026/2/16
Y1 - 2026/2/16
N2 - AIMS: The role of low-density lipoprotein cholesterol (LDL-C) in atherosclerotic cardiovascular disease in individuals aged >75 remains controversial. This study aimed to assess whether LDL-C levels are associated with coronary plaque burden and future myocardial infarctions (MI) in individuals across different ages, with focus on those aged 76-92.METHODS: This contemporary cohort study included symptomatic statin-naïve individuals who underwent coronary computed tomography angiography (CCTA) from 2008-2021, from the Western Denmark Heart Registry. Outcomes included 1) adjusted risk ratio (aRR) for CAC >90th percentile, 2) aRR for post-CCTA revascularization within 90 days of CCTA, indicating advanced atherosclerotic disease, and 3) adjusted hazard ratio (aHR) for MI.RESULTS: The study included 37,910 individuals, of whom 1,562 were aged 76-92. A total of 433 individuals experienced MI during a median follow-up time of 5.1 years. Higher LDL-C levels were associated with higher risk of CAC >90th percentile, post-CCTA revascularization, and MI across all age groups. In individuals aged 76-92, the aRRs per 1 mmol/L higher LDL-C for CAC >90th percentile and for post-CCTA revascularization were 1.19 (95% CI: 1.00-1.40) and 1.41 (1.22-1.64); corresponding values at age 61-75 years were 1.07 (1.01-1.14) and 1.32 (1.23-1.41), respectively. At age 76-92 and 61-75 years, the aHRs for MI were 1.57 (1.06-2.32) and 1.22 (1.03-1.44) per 1 mmol/L higher LDL-C.CONCLUSION: In statin-naïve symptomatic individuals aged 76-92, higher LDL-C was associated with CAC >90th percentile, post-CCTA revascularization, and increased risk of MI. These findings suggest that elevated LDL-C is a driver of coronary artery disease throughout life.
AB - AIMS: The role of low-density lipoprotein cholesterol (LDL-C) in atherosclerotic cardiovascular disease in individuals aged >75 remains controversial. This study aimed to assess whether LDL-C levels are associated with coronary plaque burden and future myocardial infarctions (MI) in individuals across different ages, with focus on those aged 76-92.METHODS: This contemporary cohort study included symptomatic statin-naïve individuals who underwent coronary computed tomography angiography (CCTA) from 2008-2021, from the Western Denmark Heart Registry. Outcomes included 1) adjusted risk ratio (aRR) for CAC >90th percentile, 2) aRR for post-CCTA revascularization within 90 days of CCTA, indicating advanced atherosclerotic disease, and 3) adjusted hazard ratio (aHR) for MI.RESULTS: The study included 37,910 individuals, of whom 1,562 were aged 76-92. A total of 433 individuals experienced MI during a median follow-up time of 5.1 years. Higher LDL-C levels were associated with higher risk of CAC >90th percentile, post-CCTA revascularization, and MI across all age groups. In individuals aged 76-92, the aRRs per 1 mmol/L higher LDL-C for CAC >90th percentile and for post-CCTA revascularization were 1.19 (95% CI: 1.00-1.40) and 1.41 (1.22-1.64); corresponding values at age 61-75 years were 1.07 (1.01-1.14) and 1.32 (1.23-1.41), respectively. At age 76-92 and 61-75 years, the aHRs for MI were 1.57 (1.06-2.32) and 1.22 (1.03-1.44) per 1 mmol/L higher LDL-C.CONCLUSION: In statin-naïve symptomatic individuals aged 76-92, higher LDL-C was associated with CAC >90th percentile, post-CCTA revascularization, and increased risk of MI. These findings suggest that elevated LDL-C is a driver of coronary artery disease throughout life.
U2 - 10.1093/eurjpc/zwag108
DO - 10.1093/eurjpc/zwag108
M3 - Journal article
C2 - 41693405
SN - 2047-4873
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
ER -