A very high prevalence of low HDL cholesterol in Spanish patients with acute coronary syndromes.
BACKGROUND
Total and low-density lipoprotein cholesterol (LDL-C) concentrations in coronary artery disease have progressively declined, although high-density lipoprotein cholesterol (HDL-C) has not always been evaluated. The prevalence and related factors of low HDL-C in a cohort of Spanish patients with acute coronary syndromes (ACS) were assessed.


METHODS
Clinical and laboratory data registered at admission and at discharge of 648 patients admitted to coronary care units of 6 Spanish hospitals for ACS between January 2004 and September 2007 were analyzed.


RESULTS
Low HDL-C (HDL-C < 1.04 mmol/L) was observed in 367 (56.6%) patients. Male gender, smoking, hypertension, diabetes, high body mass index, and triglycerides were related to low HDL-C. Female gender was the strongest protective factor against low HDL-C (0.619; 95% confidence interval [CI]: 0.410-0.934; P = 0.022), whereas high triglycerides (1.653; 95% CI: 1.323-2.064; P < 0.001) followed by previous ischemic disease (1.504; 95% CI: 1.073-2.110; P = 0.018) were the strongest factors associated with low HDL-C. One-third of patients were taking statins at admission, but only 2% were on fibrate therapy. A large increase in statin therapy, but not in other hypolipemiant drug therapy, between admission and discharge was noted in the whole cohort and among patients with low HDL-C.


CONCLUSIONS
Spanish patients with ACS have a very high prevalence of low HDL-C. Male gender, high triglycerides, and previous ischemic disease are strong, independent factors associated with this disorder. As low HDL-C remains almost completely untreated in ACS, strategies to enhance the treatment of this lipoprotein abnormality are urgently required.
Pintó
Xavier
X
Unitat de Lípids i Risc Vascular, Servei de Medicina Interna, Hospital Universitari de Bellvitge, Barcelona, Spain.
Millán
Jesús
J
Muñoz
Anna
A
Corbella
Emili
E
Hernández-Mijares
Antonio
A
Zuñiga
Manuel
M
Mangas
Alipio
A
Pedro-Botet
Juan
J
D054058:Acute Coronary Syndrome / Q000097:blood / Q000453:epidemiology*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood*; D015536:Down-Regulation; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D010343:Patient Admission; D010351:Patient Discharge; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D008076:Cholesterol, HDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides