BackgroundA low level of high-density lipoprotein cholesterol (HDL-C) is strongly associated with cardiovascular events. However, the significance of HDL-C after statin therapy on the outcome of patients who have undergone percutaneous coronary intervention (PCI) with drug eluting stents (DES) is unclear.ObjectivesTo investigate the significance of HDL-C after statin therapy on cardiovascular events in patients with coronary artery disease after DES implantation.MethodsPatients who underwent PCI with DES from January 2004 to December 2009 were prospectively enrolled. The follow-up lipid panel of 2693 patients (median lab follow-up duration 225 days) who had continued using statins after PCI and who attained low-density lipoprotein cholesterol (LDL-C) <100 mg/dl was analysed. Major adverse cardiac events (MACE), including all-cause death, non-fatal myocardial infarction, and target vessel revascularisation according to follow-up HDL-C level (40 mg/dl for men or 50 mg/dl for women) were compared with the use of propensity scores matching.ResultsMedian follow-up duration was 832 days. 1585 (58.9%) patients had low follow-up HDL-C and 1108 had high follow-up HDL-C. The low follow-up HDL-C group had significantly higher rates of MACE. Low follow-up HDL-C was a significant independent predictor of MACE (adjusted HR 1.404, 95% CI 1.111 to 1.774, p=0.004). In further analysis with propensity scores matching, overall findings were consistent.ConclusionsRaising HDL-C levels may be a subsequent goal after achieving target LDL-C levels in patients with DES implantation.

Although multivessel disease and stent diameter were associated with early TLR, late TLR was more associated with clinical comorbidities including insulin-dependent diabetes and procedural factors like the generation of the stent used and stent diameter. The risk factors for TLR may be markedly different at different time points during TLR.

The follow-up of hemoglobin level is important, and improvement of anemia is associated with favorable long-term clinical outcomes.