Evaluation of small dense low‐density lipoprotein concentration for predicting the risk of acute coronary syndrome in Chinese population

Abstract Introduction Dyslipidemia, especially an increase in the low-density lipoprotein cholesterol (LDL-C) has been established as one of the most important risk factors for atherosclerotic cardiovascular diseases. In contrast, some recent studies have shown that the low LDL-C level was associated with short-term poor prognosis in patients with cardiovascular disease, and this is so-called “cholesterol paradox”. However, there is few data evaluating the effects on long-term outcome of “cholesterol paradox” in patients with acute coronary syndrome (ACS). Purpose The purpose of this study was to examine whether the low LDL-C level on admission affect long-term prognosis in patients with ACS. Methods A total of 434 ACS patients who survived to hospital discharge were enrolled in this study. All patients were statin-naïve on admission, and were received statin therapy after hospitalization. Patients were divided into the low LDL-C (≤114 mg/dl) and high LDL-C (>114 mg/dl) groups using the first tertile of the LDL-C level on admission. The primary endpoint was composite outcomes of all-cause death, myocardial infarction, ischemic stroke, hospitalization for congestive heart failure and unplanned revascularization. Results During a median follow-up period of 5.5 years, primary endpoint occurred in 117 patients. Overall, event-free rates differed significantly between the low and high LDL-C groups, demonstrating the lower event-free rate in patients with the low LDL-C group (38.9% in low LDL-C group versus 20.7% in high LDL-C group, p=0.0002; Figure). Even after adjustment for age, sex, body mass index, and various classical risk factors, the low LDL-C group was significantly at higher risk for primary composite outcomes compared to the high LDL-C group (adjusted hazard ratio 1.65, 95%-confidence interval 1.10–2.49, p=0.02). Conclusion In patients with ACS, the low LDL-C level on admission was significantly associated with long-term worse prognosis, regardless of statin therapy at discharge. In ACS patients with low LDL-C level, it might be necessary for elucidating the residual risk for secondary adverse event to improve their prognosis. Funding Acknowledgement Type of funding source: None

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Lipid Profile of the Patient with Acute Coronary Syndromes Undergoing Coronary Angiography (CAG) in Rural Costal Region of Maharashtra

Medicina Moderna - Modern Medicine ◽

10.31689/rmm.2021.28.4.397 ◽

2021 ◽

Vol 28 (4) ◽

pp. 397-400

Author(s):

Deshpande Janhavi JAYWANT ◽

◽

Amit BHALERAO ◽

Vikas RATNAPARKHI ◽

Suryakant NISALE ◽

...

Keyword(s):

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Acute Coronary Syndrome ◽

Coronary Angiography ◽

Total Cholesterol ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Low Density ◽

Coronary Syndrome

Background: Coronary Heart Disease (CHD) is widely prevalent across the globe and significantly high level of Cholesterol in circulation is a single major risk factor associated with coronary heart disease. It is well established that cardiovascular disease is associated with hypertension and elevated blood levels of low-density lipoprotein (LDL), total cholesterol, and triglycerides. In disparity, a low level of high-density lipoprotein (HDL) is a risk factor for mortality from cardiovascular disease. Aim: The present study was conducted with the aim to assess the lipid profile in patients of Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) in rural coastal population. Patients and Methods: The present study was done on 62 patients with Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) Serum levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were examined in biochemical laboratory of the hospital. Coronary angiography was performed for the presence of lesions. Results: 43.5% of the patients (n=27) were elderly (age>60 years). Approximately 82% of the patients (n=51) aged more than 50 years. Males outnumbered females with a ratio of 2.4:1. 71% of the patients were males. Mean cholesterol levels were 177.86 mg/dl. Approx 3/4th of the patients (n=41) had cholesterol level <200 mg/Dl. Mean triglycerides levels in the patients were 158.29 mg/dl. Only 11 patients out of 62 CAD patients had abnormal triglycerides. Mean LDL level was 119.5 mg and Mean HDL level was 34.5 mg %. The high plasma concentration of low-density lipoprotein (LDL-C) in 30% and the low plasma concentration of high-density lipoprotein (HDL-C) n 33% of patients were important abnormal findings in our patients. Conclusion: Dyslipidemia as in form of very low levels of HDL cholesterol with comparatively high levels of LDL-c with near normal total Cholesterol and triglyceride levels associated with ACS in our rural costal region of Maharashtra.

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