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Optimal low-density lipoprotein cholesterol target level in Korean acute myocardial infarction patients (<70 mg/dL vs. <55 mg/dL): Based on Korea acute myocardial infarction registry-National Institute of Health

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Author(s)
Joon Ho AhnYoungkeun AhnMyung Ho JeongJu Han KimYoung Joon HongDoo Sun SimMin Chul KimKyung Hoon ChoDae Yong HyunSeung Hun LeeHyo-Soo KimHyeon Cheol GwonIn Whan SeongSeung-Ho HurSeok Kyu Oh
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Int J Cardiol
Issued Date
2021
Volume
351
Keyword
Target LDL cholesterolMyocardial infarctionKorean&lt;70 mg/dL vs. &lt;55 mg/dLPrognosis
Abstract
Background:
Current treatment guidelines for acute myocardial infarction (AMI) recommend lowering low density lipoprotein cholesterol (LDL-C). However, previous clinical studies among East Asian AMI patients failed to prove its clinical efficacy of lipid lowering therapy based on Western target LDL-C level. Thus, the purpose of this study is directly to compare the clinical outcomes of target LDL-C < 70 mg/dL and < 55 mg/dL and identify optimal target LDL-C level and in Korean AMI patients.

Methods and results:
A total of 2198 AMI patients in Korea AMI Registry – National Institute of Health were enrolled. Patients were initially divided into LDL-C non-target group ( n = 1115) and target group ( n = 1083). Successful achievement of follow up target LDL-C was defined as <70 mg/dL and ≥ 50% reduction from baseline. Target group patients were additionally divided to <70 mg/dL group ( n = 698) and <55 mg/dL group ( n = 385). Propensity score matching analysis was done in non-target vs. target group and <70 mg/dL vs. <55 mg/dL group. In the matched population, the risk of 3 years major adverse cardiac event (MACE) (13.0% vs 9.8%, HR: 0.73; 95% CI: 0.56–0.96; p = 0.025) was higher in non-target group patients. However, the risk of MACE was similar in <70 mg/dL and < 55 mg/dL group patients (10.0% vs 8.1%, HR: 0.75, 95% CI: 0.46–1.22; p = 0.247).

Conclusion:
In the present study, target LDL-C level of <70 mg/dL and ≥ 50% reduction from baseline level was associated with better clinical outcomes in Korean AMI patients. However, further lowering target LDL-C level of <55 mg/dL showed no additional benefits.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Citation
Joon Ho Ahn et al. (2021). Optimal low-density lipoprotein cholesterol target level in Korean acute myocardial infarction patients (<70 mg/dL vs. <55 mg/dL): Based on Korea acute myocardial infarction registry-National Institute of Health. Int J Cardiol, 351, 15–22. doi: 10.1016/j.ijcard.2021.12.020
Type
Article
ISSN
0167-5273
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S016752732102012X
DOI
10.1016/j.ijcard.2021.12.020
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44123
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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