JSM 2005 - Toronto

Abstract #303690

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Legend: = Applied Session, = Theme Session, = Presenter
Activity Number: 198
Type: Contributed
Date/Time: Monday, August 8, 2005 : 2:00 PM to 3:50 PM
Sponsor: Section on Statistics in Epidemiology
Abstract - #303690
Title: Associations of LDL Cholesterol in the Presence of Lipid-lowering Medications: An Imputation Approach
Author(s): Robyn McClelland*+ and Richard A. Kronmal
Companies: University of Washington and University of Washington
Address: 6200 NE 74th St, Seattle, WA, 98115, United States
Keywords: imputation ; LDL ; cholesterol
Abstract:

Many studies seek to estimate the association between LDL cholesterol and either another risk factor (e.g., genotype, race) or an outcome (e.g., mortality, subclinical disease burden). This is problematic when a large proportion of the subjects are taking lipid-lowering medications that lower LDL. For these subjects, the treated cholesterol may be observed, but the underlying "untreated" cholesterol may be the measure that is truly of interest as it is more reflective of the cumulative burden of high cholesterol. Those with highest untreated cholesterol may have some of the lowest measurements, and any relationships may be strongly attenuated. Additionally, the effect of lipid-lowering medication is confounded with the effect of LDL itself. In this presentation, we discuss methods of imputation of LDL cholesterol. Results from the metaanalysis literature will be used to estimate the untreated values as a function of the observed value, type of drug, and dose. We illustrate the methods in the setting of estimating associations of LDL cholesterol with various measures of subclinical disease in the Multi-Ethnic Study of Atherosclerosis (MESA).


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Revised March 2005