We here aim at comparing the value of total cholesterol (TC) earlier versus later in life to predict CAD and cardiovascular mortality. In a cardiovascular observation study (CVOS) we performed coronary angiography and prospectively recorded cardiovascular events over up to 19 years in 1090 patients, of whom 288 had T2DM at baseline. These patients had participated in a health survey 15 years prior to the CVOS baseline. TC was measured both at the health survey and at the baseline of the CVOS. Patients in the highest versus the lowest TC ESC/EAS SCORE category at the health survey had an OR of 6.18 [3.35-11.38]; p=0.001) for significant CAD at angiography and a HR of 9.50 [1.30-69.19]; p=0.026) for cardiovascular death after multivariate adjustment including T2DM. In contrast, TC as measured at the baseline of the CVOS was neither significantly associated with CAD nor with cardiovascular death during follow-up. ESC-SCORES were more powerful in predicting cardiovascular death when using earlier instead of recent TC (Figure), with a net reclassification improvement of 0.250, p=0.02.We conclude that TC assessed earlier in life independently of the presence of T2DM is a better predictor of CAD and of cardiovascular mortality than TC assessed later in life.


A. Leiherer: None. H. Ulmer: None. A. Muendlein: None. C.H. Saely: None. A. Vonbank: None. P. Fraunberger: None. B. Foeger: None. W. Brozek: None. G. Nagel: None. H. Drexel: None. H. Concin: None.

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