Variability in LDL Cholesterol Between Visits Predicts CV Event Risk in CAD

(HealthDay News) — Visit-to-visit variability in LDL cholesterol can independently predict cardiovascular (CV) events in individuals with coronary artery disease (CAD), according to a study published in the Journal of the American College of Cardiology.

Sripal Bangalore, MD, from the New York University School of Medicine in New York City, and colleagues examined the role of visit-to-visit variability in LDL cholesterol levels on CV outcomes. Patients enrolled in the Treating to New Targets trial were randomly assigned to receive atorvastatin 80 mg per day vs. 10 mg per day. 

Visit-to-visit LDL cholesterol variability was evaluated from 3 months into randomization using different measures.

The researchers found that standard deviation (SD) and average successive variability (ASV) were significantly lower with atorvastatin 80 mg per day vs. 10 mg per day among the 9,572 patients (P=.005 and P<.0001, respectively). 

Irrespective of treatment effect and achieved LDL cholesterol levels, each one-SD increase in LDL cholesterol variability (by ASV) correlated with increases in the risk for any coronary event (HR=1.16; 95% CI, 1.10-1.23), any CV event (HR=1.11; 95% CI, 1.07-1.15), death (HR=1.23; 95% CI, 1.14-1.34), myocardial infarction (HR=1.10; 95% CI, 1.02-1.19) and stroke (HR=1.17; 95% CI, 1.04-1.31) in the adjusted model. 

After adjustment for medication adherence the results were largely consistent.

“In subjects with coronary artery disease, visit-to-visit LDL cholesterol variability is an independent predictor of cardiovascular events,” the researchers wrote.

Several authors disclosed financial ties, including employment, to pharmaceutical companies.


  1. Bangalore S et al. J Am Coll Cardiol. 2015;65(15):1539-1548.