scholarly journals The Role of Small Dense Low-Density Lipoprotein Cholesterol in the Prediction of Acute Myocardial Infarction

2021 ◽  
Author(s):  
Ke-Lin Ma ◽  
Yi-Xiang Liu ◽  
Huang Lian ◽  
Li-Xian Sun ◽  
Chao Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Logistic Regression ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Increased Risk

Abstract Background: Acute myocardial infarction (AMI) is a common acute and severe cardiovascular disease. A growing body of evidence suggests that small dense low-density lipoprotein cholesterol (sdLDL-C) is associated with an increased risk of cardiovascular disease. This study aimed to evaluate the predictive value of different lipid indicators, particularly sdLDL-C, in the assessment of AMI.Methods: We retrospectively reviewed the hospital database for all consecutive participants who underwent coronary angiography due to the experience of chest pain in our hospital from September 2019 to June 2020. The basic demographic and clinical data and laboratory assay results for all participants were collected and evaluated at admission. Statistical analysis was performed using SPSS version 26.0.Results: A total of 216 patients with AMI, 154 patients with unstable angina pectoris (UAP) and 103 healthy subjects were included. The levels of LDL3-7 were significantly different among the three groups (P<0.05). Significant positive correlations were observed between the Gensini score and several variables, including hypertension and levels of glucose, sdLDL-C, TC, and LDL-C (r > 0.1, P < 0.001). The sdLDL-C level in the AMI group was significantly higher than that in the control group in individuals with normal LDL-C (P < 0.001). Based on the receiver operating characteristic (ROC) curves, the area under the curve (AUC) of sdLDL-C for AMI risk was 0.666, which was better than that of other lipids. Multivariate logistic regression analysis demonstrated that the sdLDL-C level was significantly correlated with AMI. A logistic regression model were established based on sdLDL-C and other variables to identify people at high cardiovascular risk, with an AUC of 0.868.Conclusions: Increased sdLDL-C level was an independent risk factor for AMI. sdLDL-C may be a useful parameter for the assessment of AMI and help clinicians classify high-risk cardiovascular disease.

Abstract 15248: Comparison of the Effects of Two Low-Density Lipoprotein Cholesterol Goals on Secondary Prevention After Acute Myocardial Infarction: ≥50% Reduction From Baseline versus <70 mg/dL

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kyung Hoon Cho ◽  
Kyoung Jin Lee ◽  
Kyung Hwan Kim ◽  
Woo-Jin Kim ◽  
Min Chul Kim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Cardiac Events ◽  
Kaplan Meier

Background: There haven’t been well-designed studies conducted to know an optimal goal for low-density lipoprotein cholesterol (LDL-C) after acute myocardial infarction (AMI). Methods: Of 2,409 consecutive patients (62.7 ± 12.4 years, 74.1% men) with AMI who had baseline LDL-C levels ≥70mg/dL and received discharge statin prescriptions after successful percutaneous coronary intervention, 1,305 patients (61.0 ± 11.8 years, 77.0% men) who had LDL-C levels tested at 1 year (mean baseline LDL-C, 126.5 ± 33.5 mg/dL; mean LDL-C reduction at 1 year, 53.1 ± 29.3 mg/dL) were analyzed in this study. Patients were categorized into 2 groups according to the values of LDL-C at 1 year in two different ways using percent change from baseline (≥50% reduction, n=428 versus <50% reduction, n=877) and fixed levels (<70 mg/L, n=625 versus ≥70 mg/dL, n=680). The primary endpoint was the composite of major cardiac events (MCEs) including cardiac deaths, non-fatal myocardial infarctions and coronary revascularizations (angioplasty or bypass grafting) after hospital discharge. A median follow-up duration was 2.0 years (interquartile range, 1.9 to 2.1 years). Results: At 2 years, MCEs occurred in 139 patients (10.7%). Kaplan-Meier estimates of the MCEs rates at 2 years revealed that patients with ≥50% LDL-C reduction from baseline had fewer MCEs compared with <50% LDL-C reduction (8.2% versus 11.9%; Log rank P =0.026), while those with LDL-C levels <70 mg/dL at 1 year did not (<70 mg/L, 10.7% versus ≥70 mg/dL, 10.6%; Log rank P =0.998). In a multivariable Cox proportional hazard model, patients with ≥50% LDL-C reduction from baseline had a 39% reduction in the risk of MCEs compared with <50% LDL-C reduction (adjusted hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.41 to 0.90; P =0.012). But, compared with LDL-C levels ≥70 mg/dL at 1 year, patients with LDL-C levels <70 mg/dL didn’t have a significant reduction in the risk of MCEs (adjusted HR, 0.98; 95% CI, 0.69 to 1.37; P =0.975). Conclusions: Obtaining a ≥50% reduction in LDL-C was associated with a significant reduction in the risk of MCEs after AMI, whereas achieving a <70 mg/dL was not. Our study suggests that obtaining a ≥50% reduction from baseline could be an optimal goal for LDL-C after AMI, not achieving a <70 mg/dL.

scholarly journals Low Density Lipoprotein Cholesterol Is Associated With Increased Risk of Cardiovascular Disease in Participants Over 70 Years Old: A Prospective Cohort Study

2021 ◽  
Author(s):  
xin Su ◽  
Deqiang Zheng ◽  
Meiping Wang ◽  
Yingting Zuo ◽  
Jing Wen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Unmeasured Confounding ◽  
Increased Risk

Abstract BackgroundPrevious studies, in which the data were collected about half a century ago, suggested that elevated low density lipoprotein cholesterol (LDL-C) is not associated with increased risk of cardiovascular disease (CVD) in patients over 70 years old. However, what is the relationship between LDL-C and CVD risk in a contemporary population aged over 70 years has not been well examined in China.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) is an ongoing nationally representative study. In this analysis, participants of CHARLS who did not taking statins and did not have heart disease and stroke at 2011 were include and were followed up to 2018. The outcome of this analysis was occurrence of CVD at follow up, which include heart disease and stroke. Cox regression was used to assess the harmful effect of LDL-C on CVD occurrence. We calculated e-values to quantify the effect of unmeasured confounding on our results.ResultsOf the 9,631 participants, 15.2% (N=1,463) were aged over 70 years and 52.5% (N=5,060) were female. During the 7 years follow-up, 1,437 participants had a first CVD attack. Risk of CVD occurrence increased 8% with each 10 mg/mL elevation in LDL-C in whole participants (adjusted HR, 1.08; 95% CI, 1.06-1.10) and age groups of ≥70 years, 60-69years and <60 years. Similar results were observed in subgroup analyses, in which participants were stratified by sex, hypertension, diabetes and chronic kidney disease. According to the restricted cubic spline, we noted a U-shaped relationship between LDL-C and risk of CVD occurrence in group over 70 years old, however, we further found that in the left side of U-shape curve, LDL-C was not associated with occurrence of CVD and its attribution to CVD occurrence was only 2.1%, which indicated that lower level of LDL-C could not increase the risk of CVD occurrence as it was demonstrated by a U-shape association. E-value analysis suggested robustness to unmeasured confounding.ConclusionsIn contemporary society of China, elevated the level of LDL-C also increased the risk of CVD in participants over 70 years old as in the relatively younger participants. These results should strengthen guideline recommendations for the use of lipid lowering therapies in those elderly.

Sign in / Sign up

Export Citation Format

Share Document