scholarly journals Impact of lipoprotein(a) on long-term outcomes after percutaneous coronary intervention in patients with reduced low-density lipoprotein cholesterol

2020 ◽  
Vol 21 (1) ◽  
pp. 147
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Long Term Outcomes ◽  
Percutaneous Coronary

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.

scholarly journals Relationship between small dense low density lipoprotein and cardiovascular events in patients with acute coronary syndrome undergoing percutaneous coronary intervention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianwei Zhang ◽  
Lingjie He
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Repeat Revascularization ◽  
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 major cardiovascular and cerebrovascular adverse events (MACCE), which was the composite of all cause of death, nonfatal myocardial infarction (MI), nonfatal stroke or 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 LDL-C were performed separately for MACCE. 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 addition, it was mainly due to the increase of unplanned repeat revascularization. In the subgroup analyses, significant association was observed regardless of level of LDL-C 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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