{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:12:22Z","timestamp":1791292342669,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"13","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020569","name":"Hong Kong Metropolitan University","doi-asserted-by":"publisher","award":["RIF\/2022\/2.2"],"award-info":[{"award-number":["RIF\/2022\/2.2"]}],"id":[{"id":"10.13039\/100020569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>This study aimed to explore relationships between visit-to-visit lipid variability, coronary artery calcification (CAC), inflammation, and long-term mortality, which may be prognostically relevant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This prospective cohort study included participants from the Multi-Ethnic Study of Atherosclerosis with available plasma LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), total cholesterol (TC), and triglycerides from all three initial exams who underwent computed tomography CAC quantification at the third (index) exam. Visit-to-visit variability (coefficient of variation) was calculated from all three initial exams. Outcomes included the index Agatston score, cardiovascular mortality, all-cause mortality, and high-sensitivity C-reactive protein. Altogether, 1515 participants were analysed. Higher HDL-C variability was associated with higher index Agatston score [Quartile 4 (Q4; vs. Q1) adjusted marginal effects 0.25\u202f0.02\u20130.48)], but not LDL-C, TC, and triglyceride variability. Over a 15.1-year median follow-up, higher HDL-C [Q4\u202fvs.\u202fQ1: adjusted sub-hazard ratio 2.68\u202f(1.61\u20134.48)] and TC [Q4\u202fvs.\u202fQ1: adjusted sub-hazard ratio 2.13\u202f(1.17\u20133.89)] variability, but not LDL-C and triglyceride variability, was associated with higher risk of cardiovascular mortality, which remained significant after adjusting for the index Agatston score. Additionally, higher HDL-C variability was associated with higher risk of all-cause mortality [Q4\u202fvs.\u202fQ1: adjusted hazard ratio 1.46\u202f(1.00\u20132.11)], but LDL-C, TC, and triglyceride variability were not. HDL-C [Q4\u202fvs.\u202fQ1: adjusted \u03b2: 0.132\u202f(0.034\u20130.230)] and TC [Q4\u202fvs.\u202fQ1: adjusted \u03b2: 0.210\u202f(0.064\u20130.357)] variability, but not LDL-C and triglyceride variability, may be correlated with high-sensitivity C-reactive protein.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Elevated HDL-C variability was associated with greater CAC burden and long-term risks of cardiovascular and all-cause mortality. These mortality-related associations were probably not completely explainable by atherosclerosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Registration<\/jats:title>\n                  <jats:p>ClinicalTrials.gov: NCT00005487.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf085","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T23:21:12Z","timestamp":1739920872000},"page":"1235-1244","source":"Crossref","is-referenced-by-count":6,"title":["Visit-to-visit lipid variability, coronary artery calcification, inflammation, and mortality in the Multi-Ethnic Study of Atherosclerosis"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0231-2393","authenticated-orcid":false,"given":"Jeffrey Shi Kai","family":"Chan","sequence":"first","affiliation":[{"name":"Cardiovascular Analytics Group, China-UK Collaboration , Hong Kong SAR 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Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Bowman Gray Center for Medical Education , 475 Vine Street, Winston-Salem, NC 27101 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adhya","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine , Bronx, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth S","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Johns Hopkins School of Medicine , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garima","family":"Sharma","sequence":"additional","affiliation":[{"name":"Inova Heart and Vascular Institute, Inova Fairfax Medical Campus , Falls Church, VA 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