Quantifying the relationship between changes in lipid variables and clinica
l endpoints has been difficult. We studied the predictive value of various
lipid variables on three endpoints in the Program on the Surgical Control o
f the Hyperlipidemias (POSCH): overall mortality, coronary heart disease (C
HD) mortality, and CHD mortality and confirmed nonfatal myocardial infarcti
on (MI) combined. We measured lipid variables for the annual visits from ba
seline to 5 years for actual follow-up values, actual and percentage differ
ences between baseline and follow-up values, as well as the parameters comp
aring baseline only to 5 years for actual differences, percentage differenc
es, and the ratio of baseline to 5 years. The lipid variables included were
total cholesterol, low density lipoprotein (LDL) cholesterol, high density
lipoprotein (HDL) cholesterol, very low density lipoprotein (VLDL) cholest
erol, triglycerides, and the LDL cholesterol/HDL cholesterol ratio. The ana
lytic method used was that of Cox regression, with age: and sex as secondar
y covariates, and each lipid or ratio of lipids as the primary (univariate)
covariate. As a result, 108 univariate Cox regressions were conducted. The
combined findings for the control and the intervention groups are presente
d. The number of events for the combined group were: overall mortality, 190
; CHD mortality, 119; and CHD mortality and confirmed nonfatal MI, 262. The
highest hazard ratios were found for the lipid variable of the LDL cholest
erol/HDL cholesterol ratio (e.g. 1.196 For a 1-unit increase). Only for the
combined endpoint of CHD mortality and confirmed nonfatal MI was there a s
ubstantial number of statistically significant relationships (P < 0.01) of
lipid variables and parameters of assessment. (C) 2001 Elsevier Science Ire
land Ltd. All rights reserved.