title: Prevalence, Predictors, and Impact of Low High-Density Lipoprotein Cholesterol on in-Hospital Outcomes Among Acute Coronary Syndrome Patients in the Middle East.
abstract: OBJECTIVE
  To estimate the prevalence, predictors, and impact of low high-density lipoprotein cholesterol (HDL-C) on in-hospital outcomes among acute coronary syndrome (ACS) patients in the Middle East.
  
  
  METHODS
  Data were collected prospectively from 6,266 consecutive patients admitted with a diagnosis of ACS and enrolled in the Gulf Registry of Acute Coronary Events (Gulf RACE). A low HDL-C was defined as a level <40 mg/Dl (1.0 mmol/L) for males and <50 mg/dL (1.3 mmol/L) for females. Analyses were performed using univariate and multivariate statistical techniques.
  
  
  RESULTS
  The overall mean age of the cohort was 56±12 years and majority were males (77%). The overall prevalence of low HDL-C was 62%. During in-hospital stay and at discharge, the majority were on statin therapy (83%) while 10% were on other cholesterol lowering agents. After adjustment of demographic and clinical characteristics, the predictors for low HDL-C were higher body mass index (BMI), prior myocardial infarction (MI), diabetes mellitus, smoking and impaired renal function. Multivariable adjustment revealed that low HDL-C was associated with higher in-hospital mortality (odds ratio (OR), 1.54; 95% CI: 1.06-2.24; p=0.022) and cardiogenic shock (OR, 1.61; 95% CI: 1.20-2.14; p=0.001).
  
  
  CONCLUSIONS
  ACS patients in the Middle East have a high prevalence of low HDL-C. Higher BMI, prior MI, diabetes mellitus, smoking, and impaired renal function were predictors of low HDL-C. Significantly higher in-hospital mortality and cardiogenic shock were associated with low HDL-C in men but not in women.
authors.affiliation: Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Rasadi
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Zakwani
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zubaid
authors.forename: Amr
authors.initials: A
authors.lastname: Ali
authors.forename: Yasser
authors.initials: Y
authors.lastname: Bahnacy
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.forename: Wael
authors.initials: W
authors.lastname: Al Mahmeed
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis