LDL-C/HDL-C and carotid plaques in patients with coronary heart disease: A Chinese cohort study

Abstract Background: Evidence of the association the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) with the carotid plaques remains limited. The purpose of this study is to examine the association between LDL-C/HDL-C and carotid plaques of coronary heart disease (CHD), and to study what extent a healthy lifestyle reduces the risk of carotid plaques.Methods: In this large-scale and multi-center retrospective study, a total of 9,426 participants to explore the association between LDL-C/HDL-C and carotid plaques. No smoking and no drinking were considered healthy lifestyle. Generalised estimating equation models and conditional logistic regressions were used in statistical analyses.Results: In all the 9,426 participants, there were 6,989 (74.15%) patients having identified carotid plaques. High levels of LDL-C/HDL-C had a higher risk of carotid plaques than other lipid variables (OR:1.63; 95%CI:1.43-1.86). In stratified analyses by LDL-C/HDL-C triplet, participants in the LDL-C/HDL-C (＞3mmol/L) group had a higher risk of carotid plaques compared to other two groups. Compared with the unfavourable lifestyle, intermediate lifestyle or favourable lifestyle was associated with a significant 30% or 67% decrease in carotid plaques risk among patients with the LDL-C/HDL-C(＞3mmol/L) respectively. There were significantly additive and multiplicative interactions between lifestyle and LDL-C/HDL-C on carotid plaques.Conclusion: Our findings provide evidence that a high level of LDL-C/HDL-C can increase the risk of carotid plaques in patients with CHD. And adhering to a healthy lifestyle has additive beneficial effects on reducing the risk of carotid plaques.