Is non-HDL-cholesterol a better predictor of long-term outcome in patients after acute myocardial infarction compared to LDL-cholesterol? : a retrospective study

Background It has recently been shown that non-high density lipoprotein cholesterol (non-HDL-C) may be a better predictor of cardiovascular risk than low density lipoprotein cholesterol (LDL-C). Based on known ethic differences in lipid parameters and cardiovascular risk prediction, we sought to study the predictability of attaining non-HDL-C target and long-term major adverse cardiovascular event (MACE) in Thai patients after acute myocardial infarction (AMI) compared to attaining LDL-C target. Methods We retrospectively obtained the data of all patients who were admitted at Maharaj Nakorn Chiang Mai hospital due to AMI during 2006–2013. The mean non-HDL-C and LDL-C during long-term follow-up were used to predict MACE at each time point. The patients were classified as target attainment if non-HDL-C <100 mg/dl and/or LDL-C <70 mg/dl. The MACE was defined as combination of all-cause death, nonfatal coronary event and nonfatal stroke. Results During mean follow-up of 2.6 ± 1.6 years among 868 patients after AMI, 34.4% achieved non-HDL-C target, 23.7% achieved LDL-C target and 21.2% experienced MACEs. LDL-C and non-HDL-C were directly compared in Cox regression model. Compared with non-HDL-C 130 mg/dl had higher incidence of MACEs (HR 3.15, 95% CI 1.46–6.80, P = 0.003). Surprisingly, LDL-C >100 mg/dl was associated with reduced risk of MACE as compared to LDL <70 mg/dl (HR 0.42, 95% CI 0.18–0.98, p = 0.046) after direct pairwise comparison with non-HDL-C level. Conclusions Non-attaining non-HDL-C goal predicted MACE at long-term follow-up after AMI whereas non-attaining LDL-C goal was not associated with the higher risk. Therefore, non-HDL-C may be a more suitable target of dyslipidemia treatment than LDL-C in patients after AMI. Electronic supplementary material The online version of this article (doi:10.1186/s12872-016-0450-9) contains supplementary material, which is available to authorized users.

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PID https://www.doi.org/10.1186/s12872-016-0450-9
PID pmid:28056802
PID pmc:PMC5217612
URL https://link.springer.com/article/10.1186/s12872-016-0450-9
URL http://dx.doi.org/10.1186/s12872-016-0450-9
URL https://paperity.org/p/79142622/is-non-hdl-cholesterol-a-better-predictor-of-long-term-outcome-in-patients-after-acute
URL https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-016-0450-9
URL https://academic.microsoft.com/#/detail/2568281451
URL https://bmccardiovascdisord.biomedcentral.com/track/pdf/10.1186/s12872-016-0450-9
URL http://link.springer.com/content/pdf/10.1186/s12872-016-0450-9.pdf
URL https://core.ac.uk/display/81280248
URL https://www.ncbi.nlm.nih.gov/pubmed/28056802
URL https://dx.doi.org/10.1186/s12872-016-0450-9
URL http://europepmc.org/articles/PMC5217612
URL https://doi.org/10.1186/s12872-016-0450-9
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Author Arintaya Phrommintikul, 0000-0003-3986-1951
Author Wanwarang Wongcharoen, 0000-0002-2418-329X
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Collected From Europe PubMed Central; PubMed Central; ORCID; Datacite; UnpayWall; Crossref; Microsoft Academic Graph; CORE (RIOXX-UK Aggregator)
Hosted By Europe PubMed Central; SpringerOpen; BMC Cardiovascular Disorders
Journal BMC Cardiovascular Disorders, 17, 1
Publication Date 2017-01-05
Publisher Springer Nature
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Language English
Resource Type Article; UNKNOWN
keyword mesheuropmc.lipids _amino acids, peptides, and proteins_
system:type publication
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Source https://science-innovation-policy.openaire.eu/search/publication?articleId=dedup_wf_001::4bf8ddd51637161c117f3e3b72230507
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Last Updated 23 December 2020, 06:11 (CET)
Created 23 December 2020, 06:11 (CET)