Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox)

Title
Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox)
Author(s)
김영조조경훈[조경훈]정명호[정명호]안영근[안영근]채승철[채승철]홍택종[홍택종]성인환[성인환]채제건[채제건]김종진[김종진]조명찬[조명찬]승기배[승기배]박승정[박승정]
Keywords
BODY-MASS INDEX; HEART-DISEASE; OUTCOMES; EVENTS; IMPACT; ATORVASTATIN; PRAVASTATIN; MORTALITY; SURVIVAL; FAILURE
Issue Date
201010
Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Citation
AMERICAN JOURNAL OF CARDIOLOGY, v.106, no.8, pp.1061 - 1068
Abstract
The relation between low-density lipoprotein (LDL) cholesterol levels and clinical outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has not been described. A total of 9,571 eligible patients (mean age 62.6 +/- 12.5 years, 6,967 men) who underwent PCI with a final diagnosis of AMI from the Korea Acute Myocardial Infarction Registry (KAMIR) were divided into 5 groups according to LDL cholesterol level: <70, 70 to 99, 100 to 129, 130 to 159, and >= 160 mg/dl. Clinical outcomes in hospital and 1 and 12 months after PCI in patients with AMI were examined. Age and co-morbidities decreased as LDL cholesterol increased. Patients with higher LDL cholesterol levels had favorable hemodynamic status and laboratory findings. Lifesaving medications, including lipid-lowering drugs, were underused in patients with lower LDL cholesterol levels. Clinical outcomes in hospital and 1 and 12 months after PCI showed better results as LDL cholesterol increased, except for patients with LDL cholesterol levels >= 160 mg/dl. In a Cox proportional-hazards model, LDL cholesterol level was not an independent predictor of mortality at 12 months, after adjusting for clinical characteristics including demographics and biologic data. In conclusion, the cholesterol paradox in patients with AMI is related to confounding by baseline characteristics associated with survival. More intensive treatment including lipid-lowering therapy for AMI in patients with lower LDL cholesterol level may result in better clinical outcomes. (C) 2010 Elsevier Inc. All rights reserved. (Am J Cardiol 2010;106:1061-1068)
URI
http://hdl.handle.net/YU.REPOSITORY/23490http://dx.doi.org/10.1016/j.amjcard.2010.06.009
ISSN
0002-9149
Appears in Collections:
의과대학 > 내과학교실 > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE