High-density lipoprotein cholesterol as a predictor of clinical outcomes in patients achieving low-density lipoprotein cholesterol targets with statins after percutaneous coronary intervention

Suk Min Seo; Eun-Ho Choo; Yoon-Seok Koh; Mahn Won Park; Dong II Shin; Yoon Seok Choi; Hun-Jun Park; Dong Bin Kim; Sung Ho Her; Jong Min Lee; Chul Soo Park; Pum-Joon Kim; Keon Woong Moon; Kiyuk Chang; Hee Yeol Kim; Ki Dong Yoo; Doo Soo Jeon; Wook Sung Chung; Yong Gyu Park; Ki-Bae Seung
December 2011
Heart;Dec2011, Vol. 97 Issue 23, p1943
Academic Journal
Background: A low level of high-density lipoprotein cholesterol (HDL-C) is strongly associated with cardiovascular events. However, the significance of HDLC after statin therapy on the outcome of patients who have undergone percutaneous coronary intervention (PCI) with drug eluting stents (DES) is unclear. Objectives: To investigate the significance of HDL-C after statin therapy on cardiovascular events in patients with coronary artery disease after DES implantation. Methods: Patients 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 lowdensity 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. Results: Median 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. Conclusions: Raising HDL-C levels may be a subsequent goal after achieving target LDL-C levels in patients with DES implantation.


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