Impact of low level of high-density lipoprotein-cholesterol sampled in overnight fasting state on the clinical outcomes in patients with acute myocardial infarction (difference between ST-segment and non-ST-segment-elevation myocardial infarction)

Abstract

Low HDL was associated with significantly higher risk of in-hospital mortality in STEMI patients, but not in NSTEMI patients. Thus, more aggressive treatment should be considered in STEMI patients with low HDL.

Multicenter Cohort Study of Acute Myocardial Infarction in Korea – Interim Analysis of the Korea Acute Myocardial Infarction Registry-National Institutes of Health Registry –

“…20 The previous KAMIR study results supported the strategy of reducing of LDL-cholesterol ≥50% from baseline. 17, 21 Recently, the Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMRPOVE-IT) study proposed that lower is better, and the role of non-statin lipid-lowering agents for improving cardiovascular outcomes. 22 In this clinical setting, the newer KAMIR-NIH registry will investigate the target of LDL-cholesterol and the effect of nonstatin agents in an Asian population.…”

Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus

“…Angeloni et al showed similar 3-year MACE rates in low and high HDL-C groups, even in patients who underwent coronary artery bypass grafting [24]. Ji et al also showed no significant difference in 1-year MACE rates between the two groups in AMI patients [25]. …”

“…Interestingly, the studies using the cut-off value of 40 mg/dL suggested that low HDL-C was an independent risk predictor [12–14]. Other studies using different cut-off values for men and women (40 mg/dL for men and 50 mg/dL for women) failed to show the significance of low HDL-C [23–25]. More importantly, 2 studies from the same AMI registry showed different results.…”

“…More importantly, 2 studies from the same AMI registry showed different results. One adopted the cut-off value of 40 mg/dL for both men and women [14], and the other study used different cut-off values for men and women (40 mg/dL for men and 50 mg/dL for women) [25]. In the present study, receiver operating characteristic (ROC) curves of HDL-C for cardiac death showed that the area under the curve (AUC) for men was 0.722 and 0.753 for women (Additional file 1: Figure S1); optimal cut-off points with the Youden index were 38 mg/dL for men and 35 mg/dL for women.…”

Changes in triglyceride, HDL-C, and non-HDL-C levels in patients with acute coronary syndrome

“…In these individuals, the benefit of LDL-C lowering with statin therapy does not correlate with the reduction of cardiovascular event rates [4]. Other studies found a strong association between low HDL-C, high triglyceride (TG) levels, and cardiovascular risk [5][6][7] even in patients on statin therapy [2]. Elevated levels of original article TG-rich lipoproteins have inflammatory, thrombotic, and atherogenic effects whereas HDL particles are generally considered to be anti-atherogenic owing to their participation in the reverse cholesterol transport and antioxidant and anti-inflammatory defense mechanisms [8].…”