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Predictive and protective role of high-density lipoprotein cholesterol in acute myocardial infarction
Affiliations- Department of Cardiology, Pusan National University Hospital, Busan, South Korea
- Medical Research Institute, Pusan National University Hospital, Busan, South Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
- Department of Cardiology, Kyungpook National University Hospital, Daegu, South Korea
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea, Republic Of
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Abstract
Background: It is unclear whether high-density lipoprotein cholesterol (HDL-C) level predicts cardiovascular events and has a protective effect in patients with acute myocardial infarction (AMI) undergo- ing percutaneous coronary intervention (PCI) and statin treatment.
Methods: A total of 15,290 AMI patients receiving statins were selected from the Korean Myocardial Infarction Registry. Baseline HDL-C level was used to identify patients with low (group A), normal (group B), and high (group C) HDL-C levels according to the Adult Treatment Panel III criteria. Clinical outcomes were compared in propensity-adjusted and matched cohorts. The primary endpoint was a composite of cardiovascular death and recurrent myocardial infarction.
Results: At the median follow-up of 11.5 months, the primary endpoint occurred in 2.7% (112/4098), 1.4% (54/3910), and 1.2% (8/661) of patients in groups A, B, and C, respectively. In the propensity- -adjusted cohort, low HDL-C level increased the risk of primary endpoint (hazard ratio [HR] 1.755, 95% confidence interval [CI] 1.274–2.417, p = 0.001), whereas high HDL-C level did not reduce this risk (HR 0.562, 95% CI 0.275–1.146, p = 0.113). In the propensity-matched cohort, low HDL-C level increased the risk of primary endpoint (HR 1.716, 95% CI 1.210–2.434, p = 0.002), whereas high HDL-C level reduced this risk (HR 0.449, 95% CI 0.214–0.946, p = 0.035).
Conclusions: In AMI patients treated with PCI and statins, low HDL-C level increases the risk of cardiovascular death and recurrent myocardial infarction, whereas high HDL-C level likely reduces the risk of cardiovascular events, especially for ST-elevation myocardial infarction.
Abstract
Background: It is unclear whether high-density lipoprotein cholesterol (HDL-C) level predicts cardiovascular events and has a protective effect in patients with acute myocardial infarction (AMI) undergo- ing percutaneous coronary intervention (PCI) and statin treatment.
Methods: A total of 15,290 AMI patients receiving statins were selected from the Korean Myocardial Infarction Registry. Baseline HDL-C level was used to identify patients with low (group A), normal (group B), and high (group C) HDL-C levels according to the Adult Treatment Panel III criteria. Clinical outcomes were compared in propensity-adjusted and matched cohorts. The primary endpoint was a composite of cardiovascular death and recurrent myocardial infarction.
Results: At the median follow-up of 11.5 months, the primary endpoint occurred in 2.7% (112/4098), 1.4% (54/3910), and 1.2% (8/661) of patients in groups A, B, and C, respectively. In the propensity- -adjusted cohort, low HDL-C level increased the risk of primary endpoint (hazard ratio [HR] 1.755, 95% confidence interval [CI] 1.274–2.417, p = 0.001), whereas high HDL-C level did not reduce this risk (HR 0.562, 95% CI 0.275–1.146, p = 0.113). In the propensity-matched cohort, low HDL-C level increased the risk of primary endpoint (HR 1.716, 95% CI 1.210–2.434, p = 0.002), whereas high HDL-C level reduced this risk (HR 0.449, 95% CI 0.214–0.946, p = 0.035).
Conclusions: In AMI patients treated with PCI and statins, low HDL-C level increases the risk of cardiovascular death and recurrent myocardial infarction, whereas high HDL-C level likely reduces the risk of cardiovascular events, especially for ST-elevation myocardial infarction.
Keywords
high-density lipoprotein cholesterol; acute myocardial infarction; cardiovascular events; statin
About this articleTitle
Predictive and protective role of high-density lipoprotein cholesterol in acute myocardial infarction
Journal
Issue
Pages
176-185
Published online
2018-03-02
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4246
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1718
DOI
Pubmed
Bibliographic record
Cardiol J 2019;26(2):176-185.
Keywords
high-density lipoprotein cholesterol
acute myocardial infarction
cardiovascular events
statin
Authors
Jin Sup Park
Kwang Soo Cha
Hye Won Lee
Jun-Hyok Oh
Jung Hyun Choi
Han Cheol Lee
Taek Jong Hong
Myung Ho Jeong
Shung Chull Chae
Young Jo Kim
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