open access

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

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
DOI: 10.5603/CJ.a2018.0020
·
Pubmed: 29512093
·
Cardiol J 2019;26(2):176-185.

open access

Vol 26, No 2 (2019)
Original articles — Clinical cardiology
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

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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