scholarly journals Relationship of High‐Density Lipoprotein Cholesterol With Periprocedural Myocardial Injury Following Elective Percutaneous Coronary Intervention in Patients With Low‐Density Lipoprotein Cholesterol Below 70 mg/dL

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Xiao‐Lin Li ◽  
Yuan‐Lin Guo ◽  
Cheng‐Gang Zhu ◽  
Rui‐Xia Xu ◽  
Ping Qing ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Lipoprotein Cholesterol ◽  
Low Density Lipoprotein Cholesterol ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Relationship Of ◽  
Periprocedural Myocardial Injury

Abstract 344: Low Density Lipoprotein Cholesterol and Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Maneesh Sud ◽  
Lu Han ◽  
Maria Koh ◽  
Husam Abdel-Qadir ◽  
Peter Austin ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiovascular Events ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Lipoprotein Cholesterol ◽  
Major Adverse Cardiovascular Events ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Percutaneous Coronary

Introduction: Lowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of major adverse cardiovascular events (MACE). Few studies have examined LDL-C control and outcomes exclusively after percutaneous coronary intervention (PCI). Furthermore, guidelines provide no formal recommendation on when to check LDL-C after PCI. It is therefore conceivable that LDL-C is not routinely measured after PCI, many patients may have elevated LDL-C levels (≥ 70mg/dL), and that elevated LDL-C levels after PCI are associated with adverse long-term outcomes. Objective: To evaluate LDL-C levels after PCI procedures, and to assess the association between LDL-C and cardiovascular events in a population-based cohort. Methods: All patients who received their first PCI between Oct 2011 and Sep 2014 in Ontario, Canada, and had a cholesterol measurement within 6 months after PCI were included. Multivariable Fine and Gray sub-distribution hazards models were used to assess the association between LDL-C measured after PCI and the incidence of MACE (myocardial infarction, coronary revascularization, stroke and cardiovascular death) through December 31, 2016. Results: There were 47,884 patients who had their first PCI during the study period, and 52% had an LDL-C measurement within 6 months post-procedure (median age 63 years, 27% female). Among them, 57% had LDL-C < 70mg/dL, 28% had LDL-C 70 to < 100mg/dL, and 15% had LDL-C ≥ 100mg/dL. After a median of 3.2 years of follow-up, 19% of patients had a qualifying MACE. After adjustment, the incidence of MACE was significantly higher in patients with higher LDL-C levels (Figure). Conclusions: Only one in two patients had LDL-C measured within 6 months after undergoing PCI and only about half had LDL-C < 70mg/dL. Higher levels of LDL-C after PCI were associated with a significantly higher incidence of MACE. Recommendations for routine LDL-C assessment and optimization may improve patient outcomes after PCI procedures.

scholarly journals Small Dense Low Density Lipoprotein and Cardiovascular Events in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Cohort Study From China

2020 ◽  
Author(s):  
Chengping Hu ◽  
Hongya Han ◽  
Yan Sun ◽  
Yujing Cheng ◽  
Yan Liu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Coronary Syndrome ◽  
Diabetes Status ◽  
Percutaneous Coronary

Abstract Background: Residual risk remained significant despite effective low density lipoprotein cholesterol (LDL-C) lowering treatment. Small dense low density lipoprotein cholesterol (sdLDL-C) as part of LDL-C has been found to be predictor of coronary heart disease (CHD) and cardiovascular (CV) events in patients with stable CHD independently of LDL-C. However, to date, few studies have explored the role of sdLDL-C in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). Accordingly, this study aimed to evaluate the association of sdLDL-C with CV events in patients with ACS undergoing PCI. Methods: Patients hospitalized with ACS undergoing PCI were enrolled and followed up for 18 months. The risk of sdLDL-C for CV events was compared according to sdLDL-C quartiles. The primary outcome was the composite of death, nonfatal myocardial infarction, nonfatal stroke and unplanned repeat revascularization. A Cox proportional hazards regression model was performed to estimate the risk of CV events. Subgroup analysis according to diabetes status and dichotomized low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) level based on median value were performed separately for cardiovascular risk.Results: A total of 6092 patients were included in the analysis (age: 60.2±10.13 years, male: 75.3%, BMI: 25.9±3.33 kg/m2, dyslipidemia: 74.1% and diabetes: 44.5 %). During 18 months of follow-up, 320 (5.2%) incident CV events occurred. Compared to the lowest sdLDL-C quartile group, patients in the highest quartile had a greater risk of CV events after multivariable adjustment (HR: 1.92; 95% CI: 1.37-2.70). In the subgroup analyses, this greater risk remained significant in patients, regardless of high or low LDL-C or TG (dichotomized by the median value) and diabetes status.Conclusions: Patients with elevated sdLDL-C have a higher risk of CV events in Chinese patients with ACS undergoing PCI, providing additional value for better risk assessment.

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