Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox)
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 underwe...
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| Veröffentlicht in: | The American journal of cardiology 2010-10, Vol.106 (8), p.1061-1068 |
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| creator | Cho, Kyung Hoon, MD Jeong, Myung Ho, MD, PhD Ahn, Youngkeun, MD, PhD Kim, Young Jo, MD, PhD Chae, Shung Chull, MD, PhD Hong, Taek Jong, MD, PhD Seong, In Whan, MD, PhD Chae, Jei Keon, MD, PhD Kim, Chong Jin, MD, PhD Cho, Myeong Chan, MD, PhD Seung, Ki Bae, MD, PhD Park, Seung Jung, MD, PhD |
| description | 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: |
| doi_str_mv | 10.1016/j.amjcard.2010.06.009 |
| format | Article |
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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.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.06.009</identifier><identifier>PMID: 20920639</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angioplasty ; Angioplasty, Balloon, Coronary - methods ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cholesterol ; Cholesterol, LDL - blood ; Clinical outcomes ; Coronary Angiography ; Coronary heart disease ; Diseases of the cardiovascular system ; Electrocardiography ; Female ; Follow-Up Studies ; Heart ; Heart attacks ; Humans ; Korea - epidemiology ; Low density lipoprotein ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - blood ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Myocarditis. Cardiomyopathies ; Patients ; Prognosis ; Prospective Studies ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Risk Factors ; Survival analysis ; Survival Rate - trends ; Time Factors</subject><ispartof>The American journal of cardiology, 2010-10, Vol.106 (8), p.1061-1068</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Oct 15, 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-d3ede3a391add9c27897a1f47cf55d79901fd518fe8dba03c7ebe9ae9efb33ae3</citedby><cites>FETCH-LOGICAL-c476t-d3ede3a391add9c27897a1f47cf55d79901fd518fe8dba03c7ebe9ae9efb33ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2010.06.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23342102$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20920639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cho, Kyung Hoon, MD</creatorcontrib><creatorcontrib>Jeong, Myung Ho, MD, PhD</creatorcontrib><creatorcontrib>Ahn, Youngkeun, MD, PhD</creatorcontrib><creatorcontrib>Kim, Young Jo, MD, PhD</creatorcontrib><creatorcontrib>Chae, Shung Chull, MD, PhD</creatorcontrib><creatorcontrib>Hong, Taek Jong, MD, PhD</creatorcontrib><creatorcontrib>Seong, In Whan, MD, PhD</creatorcontrib><creatorcontrib>Chae, Jei Keon, MD, PhD</creatorcontrib><creatorcontrib>Kim, Chong Jin, MD, PhD</creatorcontrib><creatorcontrib>Cho, Myeong Chan, MD, PhD</creatorcontrib><creatorcontrib>Seung, Ki Bae, MD, PhD</creatorcontrib><creatorcontrib>Park, Seung Jung, MD, PhD</creatorcontrib><creatorcontrib>Korea Acute Myocardial Infarction Registry (KAMIR) Investigators</creatorcontrib><creatorcontrib>Korea Acute Myocardial Infarction Registry Investigators</creatorcontrib><title>Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>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.</description><subject>Aged</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cholesterol</subject><subject>Cholesterol, LDL - blood</subject><subject>Clinical outcomes</subject><subject>Coronary Angiography</subject><subject>Coronary heart disease</subject><subject>Diseases of the cardiovascular system</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Korea - epidemiology</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Risk Factors</subject><subject>Survival analysis</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkt2O0zAQhSMEYsvCI4AsJARcpPinieMb0Kr87EpBVALEpeXaE-qQ2sV2Cn0VnhZHLYvYG64sW9-cOeMzRfGQ4DnBpH7Rz9W21yqYOcX5DddzjMWtYkYaLkoiCLtdzDDGtBRkIc6KezH2-UpIVd8tzigWFNdMzIpfrf9RvgYXbTqg1u78LvgE1qHlxg8QEwQ_oBb2MKD8uFLJgksRfbFpgy70mAC9P_jJhlUDunKdCjpZ79Cl2lv3Fa0gZEg58GNESx-8U-GQuay7z0IT-Sxt4J9uKxWU8T-f3y_udGqI8OB0nhef3775tLws2w_vrpYXbakXvE6lYWCAKSaIMkZoyhvBFekWXHdVZbgQmHSmIk0HjVkrzDSHNQgFAro1YwrYefH0qJtH_z5mF3Jro4ZhONqWvKrrmtNGZPLxDbL3Y3DZXIZ4QznHVYaqI6SDjzFAJ3fBbvPYkmA5RSd7eYpOTtFJXMscXa57dBIf11sw11V_ssrAkxOgolZDF5TTNv7lGFtQgmnmXh05yJ-2txBk1Dk1DcYG0Ekab_9r5eUNBT1YZ3PTb3CAeD00kZFKLD9OezatGZkWTNCa_QZlrNJX</recordid><startdate>20101015</startdate><enddate>20101015</enddate><creator>Cho, Kyung Hoon, MD</creator><creator>Jeong, Myung Ho, MD, PhD</creator><creator>Ahn, Youngkeun, MD, PhD</creator><creator>Kim, Young Jo, MD, PhD</creator><creator>Chae, Shung Chull, MD, PhD</creator><creator>Hong, Taek Jong, MD, PhD</creator><creator>Seong, In Whan, MD, PhD</creator><creator>Chae, Jei Keon, MD, PhD</creator><creator>Kim, Chong Jin, MD, PhD</creator><creator>Cho, Myeong Chan, MD, PhD</creator><creator>Seung, Ki Bae, MD, PhD</creator><creator>Park, Seung Jung, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20101015</creationdate><title>Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox)</title><author>Cho, Kyung Hoon, MD ; Jeong, Myung Ho, MD, PhD ; Ahn, Youngkeun, MD, PhD ; Kim, Young Jo, MD, PhD ; Chae, Shung Chull, MD, PhD ; Hong, Taek Jong, MD, PhD ; Seong, In Whan, MD, PhD ; Chae, Jei Keon, MD, PhD ; Kim, Chong Jin, MD, PhD ; Cho, Myeong Chan, MD, PhD ; Seung, Ki Bae, MD, PhD ; Park, Seung Jung, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-d3ede3a391add9c27897a1f47cf55d79901fd518fe8dba03c7ebe9ae9efb33ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cholesterol</topic><topic>Cholesterol, LDL - blood</topic><topic>Clinical outcomes</topic><topic>Coronary Angiography</topic><topic>Coronary heart disease</topic><topic>Diseases of the cardiovascular system</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Korea - epidemiology</topic><topic>Low density lipoprotein</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20920639</pmid><doi>10.1016/j.amjcard.2010.06.009</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Angioplasty Angioplasty, Balloon, Coronary - methods Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular Cholesterol Cholesterol, LDL - blood Clinical outcomes Coronary Angiography Coronary heart disease Diseases of the cardiovascular system Electrocardiography Female Follow-Up Studies Heart Heart attacks Humans Korea - epidemiology Low density lipoprotein Male Medical sciences Middle Aged Myocardial Infarction - blood Myocardial Infarction - mortality Myocardial Infarction - therapy Myocarditis. Cardiomyopathies Patients Prognosis Prospective Studies Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Risk Factors Survival analysis Survival Rate - trends Time Factors |
| title | Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox) |
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