Impact of low level of high-density lipoprotein-cholesterol sampled in overnight fasting state on the clinical outcomes in patients with acute myocardial infarction (difference between ST-segment and non-ST-segment-elevation myocardial infarction)

Korea Acute Myocardial Infarction (KAMIR) investigators

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14 Citations (Scopus)

Abstract

Background: Despite good treatment, there are residual risks in acute myocardial infarction (AMI) patients, and low level of high-density lipoprotein-cholesterol (HDL) has drawn attention as a possible cause. However, the impact of low HDL on ST-segment-elevation myocardial infarction (STEMI) compared with non-ST-segment-elevation myocardial infarction (NSTEMI) is not clear. Our aim was to evaluate the impact of low HDL on clinical outcomes in patients with STEMI or NSTEMI. Methods: We included 9270 AMI patients undergoing successful percutaneous coronary intervention. They were grouped into STEMI and NSTEMI, and subdivided into two groups according to HDL level sampled in overnight fasting state. Primary end point was in-hospital death. Secondary end point was a composite of major adverse cardiac events (MACE) in hospital survivors during one-year follow-up. Results: In the STEMI population, low HDL group showed significantly higher in-hospital death rate [4.6% vs. 1.4%, hazard ratio (HR): 2.380, 95% confidence interval (CI): 1.143-4.956, p=. 0.020] than normal HDL group. In NSTEMI population, there was no significant difference between two groups (1.8% vs. 0.9%, HR: 1.231, 95% CI: 0.649-2.335, p=. 0.525), but in subgroup analysis, very low HDL subgroup showed higher in-hospital mortality rate compared with normal HDL group (4.0% vs. 0.9%, respectively, p=. 0.009). In 12-month MACE rates, there was no significant difference between two groups in both populations. Conclusions: Low HDL was associated with significantly higher risk of in-hospital mortality in STEMI patients, but not in NSTEMI patients. Thus, more aggressive treatment should be considered in STEMI patients with low HDL.

Original languageEnglish
Pages (from-to)63-70
Number of pages8
JournalJournal of Cardiology
Volume65
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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HDL Cholesterol
Fasting
Myocardial Infarction
LDL Cholesterol
Hospital Mortality
Non-ST Elevated Myocardial Infarction
Confidence Intervals
Population
VLDL Cholesterol
Mortality
Percutaneous Coronary Intervention
Survivors
ST Elevation Myocardial Infarction
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{5939af98600d47ba8d4d29776ae57653,
title = "Impact of low level of high-density lipoprotein-cholesterol sampled in overnight fasting state on the clinical outcomes in patients with acute myocardial infarction (difference between ST-segment and non-ST-segment-elevation myocardial infarction)",
abstract = "Background: Despite good treatment, there are residual risks in acute myocardial infarction (AMI) patients, and low level of high-density lipoprotein-cholesterol (HDL) has drawn attention as a possible cause. However, the impact of low HDL on ST-segment-elevation myocardial infarction (STEMI) compared with non-ST-segment-elevation myocardial infarction (NSTEMI) is not clear. Our aim was to evaluate the impact of low HDL on clinical outcomes in patients with STEMI or NSTEMI. Methods: We included 9270 AMI patients undergoing successful percutaneous coronary intervention. They were grouped into STEMI and NSTEMI, and subdivided into two groups according to HDL level sampled in overnight fasting state. Primary end point was in-hospital death. Secondary end point was a composite of major adverse cardiac events (MACE) in hospital survivors during one-year follow-up. Results: In the STEMI population, low HDL group showed significantly higher in-hospital death rate [4.6{\%} vs. 1.4{\%}, hazard ratio (HR): 2.380, 95{\%} confidence interval (CI): 1.143-4.956, p=. 0.020] than normal HDL group. In NSTEMI population, there was no significant difference between two groups (1.8{\%} vs. 0.9{\%}, HR: 1.231, 95{\%} CI: 0.649-2.335, p=. 0.525), but in subgroup analysis, very low HDL subgroup showed higher in-hospital mortality rate compared with normal HDL group (4.0{\%} vs. 0.9{\%}, respectively, p=. 0.009). In 12-month MACE rates, there was no significant difference between two groups in both populations. Conclusions: Low HDL was associated with significantly higher risk of in-hospital mortality in STEMI patients, but not in NSTEMI patients. Thus, more aggressive treatment should be considered in STEMI patients with low HDL.",
author = "{Korea Acute Myocardial Infarction (KAMIR) investigators} and Ji, {Mi Seon} and Jeong, {Myung Ho} and Ahn, {Young Keun} and Kim, {Young Jo} and Chae, {Shung Chull} and Hong, {Taek Jong} and Seong, {In Whan} and Chae, {Jei Keon} and Kim, {Chong Jin} and Cho, {Myeong Chan} and Rha, {Seung Woon} and Bae, {Jang Ho} and Seung, {Ki Bae} and Park, {Seung Jung} and Kim, {Jong Hyun} and Hur, {Seung Ho} and Choi, {Dong Hoon} and Rhew, {Jae Young} and Kim, {Doo Il} and Chae, {In Ho} and Yoon, {Jung Han} and Koo, {Bon Kwon} and Kim, {Byung Ok} and Lee, {Myoung Yong} and Kim, {Kee Sik} and Hwang, {Jin Yong} and Oh, {Seok Kyu} and Lee, {Nae Hee} and Jeong, {Kyoung Tae} and Tahk, {Seung Jea} and Park, {Keum Soo} and Han, {Kyoo Rok} and Ahn, {Tae Hoon} and Kim, {Moo Hyun} and Chung, {Wook Sung} and Yang, {Ju Young} and Rhim, {Chong Yun} and Gwon, {Hyeon Cheol} and Park, {Seong Wook} and Koh, {Young Youp} and Joo, {Seung Jae} and Kim, {Soo Joong} and Jin, {Dong Kyu} and Cho, {Jin Man} and Jang, {Yang Soo} and Cho, {Jeong Gwan}",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.jjcc.2014.04.002",
language = "English",
volume = "65",
pages = "63--70",
journal = "Journal of Cardiology",
issn = "0914-5087",
number = "1",

}

TY - JOUR

T1 - Impact of low level of high-density lipoprotein-cholesterol sampled in overnight fasting state on the clinical outcomes in patients with acute myocardial infarction (difference between ST-segment and non-ST-segment-elevation myocardial infarction)

AU - Korea Acute Myocardial Infarction (KAMIR) investigators

AU - Ji, Mi Seon

AU - Jeong, Myung Ho

AU - Ahn, Young Keun

AU - Kim, Young Jo

AU - Chae, Shung Chull

AU - Hong, Taek Jong

AU - Seong, In Whan

AU - Chae, Jei Keon

AU - Kim, Chong Jin

AU - Cho, Myeong Chan

AU - Rha, Seung Woon

AU - Bae, Jang Ho

AU - Seung, Ki Bae

AU - Park, Seung Jung

AU - Kim, Jong Hyun

AU - Hur, Seung Ho

AU - Choi, Dong Hoon

AU - Rhew, Jae Young

AU - Kim, Doo Il

AU - Chae, In Ho

AU - Yoon, Jung Han

AU - Koo, Bon Kwon

AU - Kim, Byung Ok

AU - Lee, Myoung Yong

AU - Kim, Kee Sik

AU - Hwang, Jin Yong

AU - Oh, Seok Kyu

AU - Lee, Nae Hee

AU - Jeong, Kyoung Tae

AU - Tahk, Seung Jea

AU - Park, Keum Soo

AU - Han, Kyoo Rok

AU - Ahn, Tae Hoon

AU - Kim, Moo Hyun

AU - Chung, Wook Sung

AU - Yang, Ju Young

AU - Rhim, Chong Yun

AU - Gwon, Hyeon Cheol

AU - Park, Seong Wook

AU - Koh, Young Youp

AU - Joo, Seung Jae

AU - Kim, Soo Joong

AU - Jin, Dong Kyu

AU - Cho, Jin Man

AU - Jang, Yang Soo

AU - Cho, Jeong Gwan

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: Despite good treatment, there are residual risks in acute myocardial infarction (AMI) patients, and low level of high-density lipoprotein-cholesterol (HDL) has drawn attention as a possible cause. However, the impact of low HDL on ST-segment-elevation myocardial infarction (STEMI) compared with non-ST-segment-elevation myocardial infarction (NSTEMI) is not clear. Our aim was to evaluate the impact of low HDL on clinical outcomes in patients with STEMI or NSTEMI. Methods: We included 9270 AMI patients undergoing successful percutaneous coronary intervention. They were grouped into STEMI and NSTEMI, and subdivided into two groups according to HDL level sampled in overnight fasting state. Primary end point was in-hospital death. Secondary end point was a composite of major adverse cardiac events (MACE) in hospital survivors during one-year follow-up. Results: In the STEMI population, low HDL group showed significantly higher in-hospital death rate [4.6% vs. 1.4%, hazard ratio (HR): 2.380, 95% confidence interval (CI): 1.143-4.956, p=. 0.020] than normal HDL group. In NSTEMI population, there was no significant difference between two groups (1.8% vs. 0.9%, HR: 1.231, 95% CI: 0.649-2.335, p=. 0.525), but in subgroup analysis, very low HDL subgroup showed higher in-hospital mortality rate compared with normal HDL group (4.0% vs. 0.9%, respectively, p=. 0.009). In 12-month MACE rates, there was no significant difference between two groups in both populations. Conclusions: Low HDL was associated with significantly higher risk of in-hospital mortality in STEMI patients, but not in NSTEMI patients. Thus, more aggressive treatment should be considered in STEMI patients with low HDL.

AB - Background: Despite good treatment, there are residual risks in acute myocardial infarction (AMI) patients, and low level of high-density lipoprotein-cholesterol (HDL) has drawn attention as a possible cause. However, the impact of low HDL on ST-segment-elevation myocardial infarction (STEMI) compared with non-ST-segment-elevation myocardial infarction (NSTEMI) is not clear. Our aim was to evaluate the impact of low HDL on clinical outcomes in patients with STEMI or NSTEMI. Methods: We included 9270 AMI patients undergoing successful percutaneous coronary intervention. They were grouped into STEMI and NSTEMI, and subdivided into two groups according to HDL level sampled in overnight fasting state. Primary end point was in-hospital death. Secondary end point was a composite of major adverse cardiac events (MACE) in hospital survivors during one-year follow-up. Results: In the STEMI population, low HDL group showed significantly higher in-hospital death rate [4.6% vs. 1.4%, hazard ratio (HR): 2.380, 95% confidence interval (CI): 1.143-4.956, p=. 0.020] than normal HDL group. In NSTEMI population, there was no significant difference between two groups (1.8% vs. 0.9%, HR: 1.231, 95% CI: 0.649-2.335, p=. 0.525), but in subgroup analysis, very low HDL subgroup showed higher in-hospital mortality rate compared with normal HDL group (4.0% vs. 0.9%, respectively, p=. 0.009). In 12-month MACE rates, there was no significant difference between two groups in both populations. Conclusions: Low HDL was associated with significantly higher risk of in-hospital mortality in STEMI patients, but not in NSTEMI patients. Thus, more aggressive treatment should be considered in STEMI patients with low HDL.

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U2 - 10.1016/j.jjcc.2014.04.002

DO - 10.1016/j.jjcc.2014.04.002

M3 - Article

C2 - 25242301

AN - SCOPUS:84930145495

VL - 65

SP - 63

EP - 70

JO - Journal of Cardiology

JF - Journal of Cardiology

SN - 0914-5087

IS - 1

ER -