Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry

Abstract Lipid variability (LV) has been studied and proposed as a potential predictor for cardiovascular disease (CVD), and increased LV may contribute to adverse clinical outcomes. This study aimed to investigate the association of various LV parameters with the risk of long-term major adverse car...

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Main Authors: Chutithep Teekaput, Kitti Thiankhaw, Wanwarang Wongcharoen, Narawudt Prasertwitayakij, Siriluck Gunaparn, Arintaya Phrommintikul
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-85453-w
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author Chutithep Teekaput
Kitti Thiankhaw
Wanwarang Wongcharoen
Narawudt Prasertwitayakij
Siriluck Gunaparn
Arintaya Phrommintikul
author_facet Chutithep Teekaput
Kitti Thiankhaw
Wanwarang Wongcharoen
Narawudt Prasertwitayakij
Siriluck Gunaparn
Arintaya Phrommintikul
author_sort Chutithep Teekaput
collection DOAJ
description Abstract Lipid variability (LV) has been studied and proposed as a potential predictor for cardiovascular disease (CVD), and increased LV may contribute to adverse clinical outcomes. This study aimed to investigate the association of various LV parameters with the risk of long-term major adverse cardiovascular events (MACE) among the Thai population. The study used data from the CORE-Thailand Registry, a prospective multicentre study of adults with high cardiovascular risk or established CVD. The primary outcome was 4-point MACE, including non-fatal myocardial infarction, non-fatal stroke, heart failure hospitalisation, and all-cause mortality. LV was defined as visit-to-visit variability in individual and combined lipid parameters using the coefficient of variation (CV), and patients were stratified into four groups according to CV quartiles. The hazard ratio (HR) and 95% confidence interval (CI), adjusted for potential confounders, were calculated using the Cox proportional hazards model. In a total of 9,390 patients, 6,041 patients with data of intra-individual LV were included. After adjusting covariates in the Cox proportional hazards model, higher LV was independently associated with an increased risk of 4-point MACE (HR for quartiles 2, 3, and 4 of the CV of total cholesterol, compared to first quartile, were 3.63 (95% CI 3.20–4.06, P < 0.001), 6.85 (95% CI 6.23–7.47, P < 0.001), and 8.91 (95% CI 8.18–9.64, P < 0.001), respectively). The present study demonstrated that higher visit-to-visit LV, particularly in the higher quartiles, was independently associated with MACE, MI, and all-cause mortality in the Thai population at high cardiovascular risk or established atherosclerotic CVD, indicating that LV might be useful as a potential risk indicator.
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spelling doaj-art-1935be414c784dc892a14051789b4f812025-01-19T12:23:29ZengNature PortfolioScientific Reports2045-23222025-01-0115111110.1038/s41598-025-85453-wVisit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registryChutithep Teekaput0Kitti Thiankhaw1Wanwarang Wongcharoen2Narawudt Prasertwitayakij3Siriluck Gunaparn4Arintaya Phrommintikul5Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityAbstract Lipid variability (LV) has been studied and proposed as a potential predictor for cardiovascular disease (CVD), and increased LV may contribute to adverse clinical outcomes. This study aimed to investigate the association of various LV parameters with the risk of long-term major adverse cardiovascular events (MACE) among the Thai population. The study used data from the CORE-Thailand Registry, a prospective multicentre study of adults with high cardiovascular risk or established CVD. The primary outcome was 4-point MACE, including non-fatal myocardial infarction, non-fatal stroke, heart failure hospitalisation, and all-cause mortality. LV was defined as visit-to-visit variability in individual and combined lipid parameters using the coefficient of variation (CV), and patients were stratified into four groups according to CV quartiles. The hazard ratio (HR) and 95% confidence interval (CI), adjusted for potential confounders, were calculated using the Cox proportional hazards model. In a total of 9,390 patients, 6,041 patients with data of intra-individual LV were included. After adjusting covariates in the Cox proportional hazards model, higher LV was independently associated with an increased risk of 4-point MACE (HR for quartiles 2, 3, and 4 of the CV of total cholesterol, compared to first quartile, were 3.63 (95% CI 3.20–4.06, P < 0.001), 6.85 (95% CI 6.23–7.47, P < 0.001), and 8.91 (95% CI 8.18–9.64, P < 0.001), respectively). The present study demonstrated that higher visit-to-visit LV, particularly in the higher quartiles, was independently associated with MACE, MI, and all-cause mortality in the Thai population at high cardiovascular risk or established atherosclerotic CVD, indicating that LV might be useful as a potential risk indicator.https://doi.org/10.1038/s41598-025-85453-wLipid variabilityTotal cholesterolCoefficient of variationMajor adverse cardiovascular events
spellingShingle Chutithep Teekaput
Kitti Thiankhaw
Wanwarang Wongcharoen
Narawudt Prasertwitayakij
Siriluck Gunaparn
Arintaya Phrommintikul
Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry
Scientific Reports
Lipid variability
Total cholesterol
Coefficient of variation
Major adverse cardiovascular events
title Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry
title_full Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry
title_fullStr Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry
title_full_unstemmed Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry
title_short Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry
title_sort visit to visit lipid variability on long term major adverse cardiovascular events a prospective multicentre cohort from the core thailand registry
topic Lipid variability
Total cholesterol
Coefficient of variation
Major adverse cardiovascular events
url https://doi.org/10.1038/s41598-025-85453-w
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