open access

Vol 26, No 2 (2019)
Original articles — Clinical cardiology
Submitted: 2016-05-26
Accepted: 2016-08-11
Published online: 2018-03-02
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Predictive and protective role of high-density lipoprotein cholesterol in acute myocardial infarction

Jin Sup Park12, Kwang Soo Cha12, Hye Won Lee1, Jun-Hyok Oh1, Jung Hyun Choi1, Han Cheol Lee1, Taek Jong Hong1, Myung Ho Jeong3, Shung Chull Chae4, Young Jo Kim5
·
Pubmed: 29512093
·
Cardiol J 2019;26(2):176-185.
Affiliations
  1. Department of Cardiology, Pusan National University Hospital, Busan, South Korea
  2. Medical Research Institute, Pusan National University Hospital, Busan, South Korea
  3. Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
  4. Department of Cardiology, Kyungpook National University Hospital, Daegu, South Korea
  5. Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea, Republic Of

open access

Vol 26, No 2 (2019)
Original articles — Clinical cardiology
Submitted: 2016-05-26
Accepted: 2016-08-11
Published online: 2018-03-02

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. 

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Keywords

high-density lipoprotein cholesterol; acute myocardial infarction; cardiovascular events; statin

About this article
Title

Predictive and protective role of high-density lipoprotein cholesterol in acute myocardial infarction

Journal

Cardiology Journal

Issue

Vol 26, No 2 (2019)

Pages

176-185

Published online

2018-03-02

Page views

4246

Article views/downloads

1718

DOI

10.5603/CJ.a2018.0020

Pubmed

29512093

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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