Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus

Hyung Joon Joo, Sang A. Cho, Soon Jun Hong, Seung Ho Hur, Jang Ho Bae, Dong Ju Choi, Young Keun Ahn, Jong Seon Park, Rak Kyeong Choi, Donghoon Choi, Joon Hong Kim, Kyoo Rok Han, Hun Sik Park, So Yeon Choi, Junghan Yoon, Hyeon Cheol Kwon, Seung Woon Rha, Kyung Kuk Hwang, Kyung Tae Jung, Seok Kyu Oh & 5 others Jae Hwan Lee, Eun Seok Shin, Kee Sik Kim, Hyo Soo Kim, Do Sun Lim

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Abstract

Background: It is still unclear whether low high-density lipoprotein cholesterol (HDL-C) affects cardiovascular outcomes after acute myocardial infarction (AMI), especially in patients with diabetes mellitus. Methods: A total of 984 AMI patients with diabetes mellitus from the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry were divided into two groups based on HDL-C level on admission: normal HDL-C group (HDL-C ≥ 40 mg/dL, n = 519) and low HDL-C group (HDL-C < 40 mg/dL, n = 465). The primary endpoint was 2-year major adverse cardiovascular events (MACE), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target vessel revascularization (TVR). Results: The median follow-up duration was 730 days. The 2-year MACE rates were significantly higher in the low HDL-C group than in the normal HDL-C group (MACE, 7.44% vs. 3.49%, p = 0.006; cardiac death, 3.72% vs. 0.97%, p = 0.004; non-fatal MI, 1.75% vs. 1.55%, p = 0.806; TVR, 3.50% vs. 0.97%, p = 0.007). Kaplan-Meier analysis revealed that the low HDL-C group had a significantly higher incidence of MACE compared to the normal HDL-C group (log-rank p = 0.013). After adjusting for conventional risk factors, Cox proportional hazards analysis suggested that low HDL-C was an independent risk predictor for MACE (hazard ratio [HR] 3.075, 95% confidence interval [CI] 1.034-9.144, p = 0.043). Conclusions: In patients with diabetes mellitus, low HDL-C remained an independent risk predictor for MACE after adjusting for multiple risk factors during 2-year follow-up of AMI. Trial registration: This study was the sub-analysis of the prospective multi-center registry of DIAMOND (Diabetic acute myocardial infarction Disease) in Korea. This is the observational study supported by Bayer HealthCare, Korea. Study number is 15614. First patient first visit was 02 April 2010 and last patient last visit was 09 December 2013.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalLipids in Health and Disease
Volume15
Issue number1
DOIs
Publication statusPublished - 2016 Nov 18

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Medical problems
LDL Cholesterol
HDL Cholesterol
Diabetes Mellitus
Myocardial Infarction
Korea
Cardiomyopathies
Registries
Hazards
Kaplan-Meier Estimate
Observational Studies
Confidence Intervals
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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Joo, Hyung Joon ; Cho, Sang A. ; Hong, Soon Jun ; Hur, Seung Ho ; Bae, Jang Ho ; Choi, Dong Ju ; Ahn, Young Keun ; Park, Jong Seon ; Choi, Rak Kyeong ; Choi, Donghoon ; Kim, Joon Hong ; Han, Kyoo Rok ; Park, Hun Sik ; Choi, So Yeon ; Yoon, Junghan ; Kwon, Hyeon Cheol ; Rha, Seung Woon ; Hwang, Kyung Kuk ; Jung, Kyung Tae ; Oh, Seok Kyu ; Lee, Jae Hwan ; Shin, Eun Seok ; Kim, Kee Sik ; Kim, Hyo Soo ; Lim, Do Sun. / Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus. In: Lipids in Health and Disease. 2016 ; Vol. 15, No. 1. pp. 1-8.
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abstract = "Background: It is still unclear whether low high-density lipoprotein cholesterol (HDL-C) affects cardiovascular outcomes after acute myocardial infarction (AMI), especially in patients with diabetes mellitus. Methods: A total of 984 AMI patients with diabetes mellitus from the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry were divided into two groups based on HDL-C level on admission: normal HDL-C group (HDL-C ≥ 40 mg/dL, n = 519) and low HDL-C group (HDL-C < 40 mg/dL, n = 465). The primary endpoint was 2-year major adverse cardiovascular events (MACE), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target vessel revascularization (TVR). Results: The median follow-up duration was 730 days. The 2-year MACE rates were significantly higher in the low HDL-C group than in the normal HDL-C group (MACE, 7.44{\%} vs. 3.49{\%}, p = 0.006; cardiac death, 3.72{\%} vs. 0.97{\%}, p = 0.004; non-fatal MI, 1.75{\%} vs. 1.55{\%}, p = 0.806; TVR, 3.50{\%} vs. 0.97{\%}, p = 0.007). Kaplan-Meier analysis revealed that the low HDL-C group had a significantly higher incidence of MACE compared to the normal HDL-C group (log-rank p = 0.013). After adjusting for conventional risk factors, Cox proportional hazards analysis suggested that low HDL-C was an independent risk predictor for MACE (hazard ratio [HR] 3.075, 95{\%} confidence interval [CI] 1.034-9.144, p = 0.043). Conclusions: In patients with diabetes mellitus, low HDL-C remained an independent risk predictor for MACE after adjusting for multiple risk factors during 2-year follow-up of AMI. Trial registration: This study was the sub-analysis of the prospective multi-center registry of DIAMOND (Diabetic acute myocardial infarction Disease) in Korea. This is the observational study supported by Bayer HealthCare, Korea. Study number is 15614. First patient first visit was 02 April 2010 and last patient last visit was 09 December 2013.",
author = "Joo, {Hyung Joon} and Cho, {Sang A.} and Hong, {Soon Jun} and Hur, {Seung Ho} and Bae, {Jang Ho} and Choi, {Dong Ju} and Ahn, {Young Keun} and Park, {Jong Seon} and Choi, {Rak Kyeong} and Donghoon Choi and Kim, {Joon Hong} and Han, {Kyoo Rok} and Park, {Hun Sik} and Choi, {So Yeon} and Junghan Yoon and Kwon, {Hyeon Cheol} and Rha, {Seung Woon} and Hwang, {Kyung Kuk} and Jung, {Kyung Tae} and Oh, {Seok Kyu} and Lee, {Jae Hwan} and Shin, {Eun Seok} and Kim, {Kee Sik} and Kim, {Hyo Soo} and Lim, {Do Sun}",
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Joo, HJ, Cho, SA, Hong, SJ, Hur, SH, Bae, JH, Choi, DJ, Ahn, YK, Park, JS, Choi, RK, Choi, D, Kim, JH, Han, KR, Park, HS, Choi, SY, Yoon, J, Kwon, HC, Rha, SW, Hwang, KK, Jung, KT, Oh, SK, Lee, JH, Shin, ES, Kim, KS, Kim, HS & Lim, DS 2016, 'Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus', Lipids in Health and Disease, vol. 15, no. 1, pp. 1-8. https://doi.org/10.1186/s12944-016-0374-5

Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus. / Joo, Hyung Joon; Cho, Sang A.; Hong, Soon Jun; Hur, Seung Ho; Bae, Jang Ho; Choi, Dong Ju; Ahn, Young Keun; Park, Jong Seon; Choi, Rak Kyeong; Choi, Donghoon; Kim, Joon Hong; Han, Kyoo Rok; Park, Hun Sik; Choi, So Yeon; Yoon, Junghan; Kwon, Hyeon Cheol; Rha, Seung Woon; Hwang, Kyung Kuk; Jung, Kyung Tae; Oh, Seok Kyu; Lee, Jae Hwan; Shin, Eun Seok; Kim, Kee Sik; Kim, Hyo Soo; Lim, Do Sun.

In: Lipids in Health and Disease, Vol. 15, No. 1, 18.11.2016, p. 1-8.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus

AU - Joo, Hyung Joon

AU - Cho, Sang A.

AU - Hong, Soon Jun

AU - Hur, Seung Ho

AU - Bae, Jang Ho

AU - Choi, Dong Ju

AU - Ahn, Young Keun

AU - Park, Jong Seon

AU - Choi, Rak Kyeong

AU - Choi, Donghoon

AU - Kim, Joon Hong

AU - Han, Kyoo Rok

AU - Park, Hun Sik

AU - Choi, So Yeon

AU - Yoon, Junghan

AU - Kwon, Hyeon Cheol

AU - Rha, Seung Woon

AU - Hwang, Kyung Kuk

AU - Jung, Kyung Tae

AU - Oh, Seok Kyu

AU - Lee, Jae Hwan

AU - Shin, Eun Seok

AU - Kim, Kee Sik

AU - Kim, Hyo Soo

AU - Lim, Do Sun

PY - 2016/11/18

Y1 - 2016/11/18

N2 - Background: It is still unclear whether low high-density lipoprotein cholesterol (HDL-C) affects cardiovascular outcomes after acute myocardial infarction (AMI), especially in patients with diabetes mellitus. Methods: A total of 984 AMI patients with diabetes mellitus from the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry were divided into two groups based on HDL-C level on admission: normal HDL-C group (HDL-C ≥ 40 mg/dL, n = 519) and low HDL-C group (HDL-C < 40 mg/dL, n = 465). The primary endpoint was 2-year major adverse cardiovascular events (MACE), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target vessel revascularization (TVR). Results: The median follow-up duration was 730 days. The 2-year MACE rates were significantly higher in the low HDL-C group than in the normal HDL-C group (MACE, 7.44% vs. 3.49%, p = 0.006; cardiac death, 3.72% vs. 0.97%, p = 0.004; non-fatal MI, 1.75% vs. 1.55%, p = 0.806; TVR, 3.50% vs. 0.97%, p = 0.007). Kaplan-Meier analysis revealed that the low HDL-C group had a significantly higher incidence of MACE compared to the normal HDL-C group (log-rank p = 0.013). After adjusting for conventional risk factors, Cox proportional hazards analysis suggested that low HDL-C was an independent risk predictor for MACE (hazard ratio [HR] 3.075, 95% confidence interval [CI] 1.034-9.144, p = 0.043). Conclusions: In patients with diabetes mellitus, low HDL-C remained an independent risk predictor for MACE after adjusting for multiple risk factors during 2-year follow-up of AMI. Trial registration: This study was the sub-analysis of the prospective multi-center registry of DIAMOND (Diabetic acute myocardial infarction Disease) in Korea. This is the observational study supported by Bayer HealthCare, Korea. Study number is 15614. First patient first visit was 02 April 2010 and last patient last visit was 09 December 2013.

AB - Background: It is still unclear whether low high-density lipoprotein cholesterol (HDL-C) affects cardiovascular outcomes after acute myocardial infarction (AMI), especially in patients with diabetes mellitus. Methods: A total of 984 AMI patients with diabetes mellitus from the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry were divided into two groups based on HDL-C level on admission: normal HDL-C group (HDL-C ≥ 40 mg/dL, n = 519) and low HDL-C group (HDL-C < 40 mg/dL, n = 465). The primary endpoint was 2-year major adverse cardiovascular events (MACE), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target vessel revascularization (TVR). Results: The median follow-up duration was 730 days. The 2-year MACE rates were significantly higher in the low HDL-C group than in the normal HDL-C group (MACE, 7.44% vs. 3.49%, p = 0.006; cardiac death, 3.72% vs. 0.97%, p = 0.004; non-fatal MI, 1.75% vs. 1.55%, p = 0.806; TVR, 3.50% vs. 0.97%, p = 0.007). Kaplan-Meier analysis revealed that the low HDL-C group had a significantly higher incidence of MACE compared to the normal HDL-C group (log-rank p = 0.013). After adjusting for conventional risk factors, Cox proportional hazards analysis suggested that low HDL-C was an independent risk predictor for MACE (hazard ratio [HR] 3.075, 95% confidence interval [CI] 1.034-9.144, p = 0.043). Conclusions: In patients with diabetes mellitus, low HDL-C remained an independent risk predictor for MACE after adjusting for multiple risk factors during 2-year follow-up of AMI. Trial registration: This study was the sub-analysis of the prospective multi-center registry of DIAMOND (Diabetic acute myocardial infarction Disease) in Korea. This is the observational study supported by Bayer HealthCare, Korea. Study number is 15614. First patient first visit was 02 April 2010 and last patient last visit was 09 December 2013.

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DO - 10.1186/s12944-016-0374-5

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