Abstract 16643: Very Low LDL Cholesterol Level Below 50mg/dL is Not Harmful for Patients Underwent Percutaneous Coronary Intervention in Drug Eluting Stent Era
Introduction There has been the paucity of data for the safety of very low LDL-cholesterol level below 50 mg/dL in patients with coronary artery disease who underwent percutaneous coronary intervention.
Hypothesis Very low LDL-C level may be safe in patients underwent PCI in terms of major adverse cardiac event including death, nonfatal myocardial infarction, stroke or revascularization of any cause.
Methods We analyzed a total 9,292 consecutive patients who underwent PCI using drug eluting stent from January 2004 to December 2009. Among these, 2704 subjects who had initial and follow-up lipid panel and attained low LDL-cholesterol (LDL-C<100mg/dL) with statin therapy were enrolled. Median follow up period was 28.3 months (interquartile range 15.1, 41.5 months). Laboratory study was performed at the time of index drug-eluting stent implantation and at the outpatient visit between three and twelve months later. We categorized patients into three groups based on the follow-up LDL-cholesterol level : <50, 50 to 70, 71 to 100 mg/dL(n=399, 1028, 1277, respectively). We compared major adverse cardiac events including all-cause death, nonfatal myocardial infarction, stroke and revascularization of any cause according to the follow up LDL-cholesterol group.
Results Multivariable Cox regression analysis revealed that in the patients with well controlled follow up LDL-C level (LDL<100 mg/dL), multivessel disease, presence of angiographic AHA/B2C lesion were strongly associated with increase in a hazard ratio of a composite of death, myocardial infarction, strtoke and revascularization of any cause. But LDL-C was not associated with the occurrence of MACEs. (Table 1.)
Conclusions In patients who underwent PCI with DES and well controlled LDL level, cholesterol paradox is not observed. It may be safe in patients with very low LDL-C level below 50 mg/dL in spite of continuous use of statin in terms of MACEs. Keywords lipoprotein, hyperlipidemia, coronary heart disease, PCI
- © 2011 by American Heart Association, Inc.