Abstract 16528: Predictive and Protective Value of High Density Lipoprotein-Cholesterol for Cardiovascular Events in Patients With Acute Myocardial Infarction Who had Percutaneous Coronary Intervention and Statin Treatment
Introduction: Low level of high density lipoprotein-cholesterol (HDL-C) has been identified as a residual risk of cardiovascular events after lowering low density lipoprotein-cholesterol (LDL-C) in patients with stable coronary artery disease. Further, high HDL-C level is proven to have a protective effect for cardiovascular events in primary prevention studies.
Hypothesis: We assessed the hypothesis that we evaluated whether the HDL-C level may have predictive and protective value in patients with acute myocardial infarction (MI) who had percutaneous coronary intervention (PCI) and statin treatment.
Methods: A total of 15,938 patients who had PCI and statin treatment were selected from the Korean Myocardial Infarction registry. According to the ATP III criteria, baseline HDL-C level was used to identify patients with low HDL-C (<40 mg/dL, Group A), normal HDL-C (≥40 to < 60 mg/dL, Group B), or high HDL-C (≥60 mg/dL, Group C). Major adverse cardiac events (MACE) at one-year, the primary endpoint, were compared in Cox proportional hazard regression models.
Results: At median follow-up of 11.5 months, cardiovascular death occurred 2.4% (145/6075) in Group A, 1.9% (164/8643) in Group B, and 2.2% (26/1220) in Group C. The total MACE occurred 8.3% (505/6075) in Group A, 7.6% (661/8643) in Group B, and 7.7% (94/1220) in Group C. The low HDL-C level was associated with increased risk of cardiovascular death (hazard ratio [HR] 1.587, 95% confidence interval [CI] 1.137-2.215, p = 0.007), but not with increased risk with the total MACE (HR 1.005, 95% CI 0.881-1.147, p = 0.943). The high HDL-C level was not associated with reduced risk of both the cardiovascular death (HR 0.66, 95% CI 0.322-1.351, p = 0.256) and the total MACE (HR 0.977, 95% CI 0.772-1.239, p = 0.847).
Conclusions: In acute MI patients treated with PCI and statin, low HDL-C was associated with increased cardiovascular death, but not with increased total cardiovascular events. However, high HDL-C was not associated with reduced risk of both cardiovascular death and the total cardiovascular events in these patients. This study supports that the functioning HDL-C is more important than the raised HDL-C level in these patients.
Author Disclosures: J. Park: None. K. Cha: None. D. Shin: None. D. Lee: None. H. Lee: None. J. Oh: None. J. Choi: None. H. Lee: None. T. Hong: None.
- © 2014 by American Heart Association, Inc.