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Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox)

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Author(s)
Kyung Hoon ChoMyung Ho JeongYoungkeun AhnYoung Jo KimShung Chull ChaeTaek Jong HongIn Whan SeongJei Keon ChaeChong Jin KimMyeong Chan ChoKi Bae SeungSeung Jung Park
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
American Journal of Cardiology
Issued Date
2010
Volume
106
Issue
8
Abstract
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. © 2010 Elsevier Inc. All rights
reserved. (Am J Cardiol 2010;106:1061–1068)
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Kyung Hoon Cho et al. (2010). Low-Density Lipoprotein Cholesterol Level in Patients With Acute Myocardial Infarction Having Percutaneous Coronary Intervention (the Cholesterol Paradox). American Journal of Cardiology, 106(8), 1061–1068. doi: 10.1016/j.amjcard.2010.06.009
Type
Article
ISSN
0002-9149
Source
https://linkinghub.elsevier.com/retrieve/pii/S0002914910011926
DOI
10.1016/j.amjcard.2010.06.009
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34922
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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