Open AccessRelationship between low‐density lipoprotein levels on admission and 1‐year outcome in patients with acute ST‐segment‐elevation myocardial infarction
Author(s) -
Sun YuJiao,
Li YuZe,
Jiang DaMing,
Zhang Bo,
Gao Yuan,
Zhang ZhiHong,
Qi GuoXian
Publication year - 2013
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/j.kjms.2012.08.036
Subject(s) - medicine , mace , myocardial infarction , incidence (geometry) , hazard ratio , proportional hazards model , cardiology , percutaneous coronary intervention , confidence interval , physics , optics
This study assessed the relationship between low‐density lipoprotein cholesterol (LDL‐C) levels on admission and the incidence of major adverse cardiovascular events (MACE) in patients with acute ST‐segment‐elevation myocardial infarction (ASTEMI). Patients with ASTEMI who had a lipid profile tested within 24 hours of symptom onset were enrolled. They were stratified into high and low LDL‐C groups according to whether their LDL‐C was above ( n = 501) or below ( n = 575) the median level, respectively. The incidence of MACE, cardiovascular death, non‐fatal MI, revascularization, and stroke was compared between the groups at 1 month, 6 months, and 1 year. Survival analysis and Cox proportional hazard analysis were performed. In‐hospital use of beta blockers was better in the high than in the low LDL‐C group (76.6% vs. 69.7%, p = 0.01). Statin use was significantly higher in the high than in the low LDL‐C group during follow‐up (86.8% vs. 80.0%, p = 0.003 at1 month; 71.6% vs. 62.4%, p = 0.002 at 6 months; 67.8% vs. 61.2%, p = 0.03 at 1 year). The incidence of MACE on follow‐up at 1 month was higher in the low than in the high LDL‐C group (12.0% vs. 8.1%, p = 0.04). At 1 year, survival was not significantly different between the groups. Cox proportional hazards analysis indicated that the incidence of MACE was significantly associated with hypertension, current smoking, high‐density lipoprotein cholesterol (HDL‐C), in‐hospital use of beta blockers, and statin use on follow‐up ( p < 0.01). LDL‐C levels on admission in patients with ASTEMI had no significant effect on the 6‐month and 1‐year incidence of MACE, but the incidence of MACE was significantly higher in the low LDL‐C group at 1 month. It would be relevant to further investigate the HDL‐C level on admission, in‐hospital use of beta blockers, and statin use during follow‐up in relation to MACE.