Abstract 4197: Contemporary Lipid Levels in Patients Hospitalized With Acute ST-Segment Elevation Myocardial Infarction
Background: Admission levels of lipids among a contemporary population of patients hospitalized with acute ST-segment elevation myocardial infarction (STEMI) have not been well studied. This study aimed to analyze admission lipid levels in a broad contemporary population of patients hospitalized with STEMI.
Methods: Data was collected on 790 consecutive STEMI patients undergoing primary percutaneous coronary intervention within 12 hours of symptom onset between January 1, 2002 and June 30, 2008. Patient characteristics, in-hospital procedures data, admission laboratories and use of lipid-lowering medication before hospitalization were collected (table⇓). Lipid levels obtained within 24 hours of admission were analyzed in 74% of the patients.
Results: Median lipid levels were: non-HDL-C 133.5, LDL 103, HDL 37 and triglyceride 137 mg/dL. Of the broad cohort of hospitalized STEMI patients, admission non-HDL-C <100 mg/dL was observed in 25.2%, while only 19.6% had LDL <70 mg/dL. About 64% had HDL levels <40 mg/dL, and only 4% had HDL ≥60 mg/dL. In patients with history of CAD, other atherosclerotic vascular disease, or diabetes, ideal levels (non-HDL-C <100, LDL <70 and HDL ≥60 mg/dL) were observed in only 29%, 4%, and 24%, respectively. Only one-third of the high-risk patients were on lipid-lowering medications. See table⇓ for baseline data. Multivariate analysis determined the following to be independent predictors of a dyslipidemic profile (high non-HDL-C/LDL levels and lower HDL levels): age ≥75 years, hypertension, smoking and history of hyperlipidemia.
Conclusion: Our observations show that almost 70% of high-risk patients who sustained STEMI show inadequate control of key lipoproteins. Aggressive management of lipid levels to targets as recommended in NCEP’s ATP III guidelines is suggested.