Nonoptimal high-density lipoprotein cholesterol levels are highly prevalent in patients presenting with acute coronary syndromes and well-controlled low-density lipoprotein cholesterol levels.
BACKGROUND
Low levels of high-density lipoprotein cholesterol (HDL-C) are an independent risk factor for coronary artery disease. For this study, nonoptimal HDL-C is defined as less than 40 mg/dL for male patients and less than 50 mg/dL for female patients. Even when low-density lipoprotein cholesterol (LDL-C) and non-HDL-C goals are met, significant risk for subsequent cardiovascular events remains in patients with acute coronary syndrome (ACS).


OBJECTIVE
This study is a prospective, observational study to determine the prevalence of low HDL-C levels in 250 consecutive patients presenting with ACS who have well-controlled LDL-C levels.


METHODS
This was an institutional review board-approved, prospective, observational study in which we evaluated consecutive patients admitted to the adult general cardiology service with a diagnosis of ACS.


RESULTS
One hundred nine (44%) patients had LDL-C levels less than 100 mg/dL on admission. Of those patients, 90 (83%) had a nonoptimal HDL-C. Interestingly, a majority of patients, 94 (86%), had non-HDL-C levels at target. At discharge, approximately one half of eligible patients were started on therapy to increase their HDL-C levels.


CONCLUSIONS
In conclusion, nonoptimal HDL-C levels are highly prevalent in patients presenting with ACS and reasonably controlled LDL-C and non-HDL-C levels.
Division of Cardiology, Department of Medicine, Preventive Cardiology Center, Vascular Function Study Group, Tufts Medical Center, 800 Washington Street, Box 80, Boston, MA 02111, USA.
Erika M
EM
Felix-Getzik
Jeffrey T
JT
Kuvin
Richard H
RH
Karas
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL