title: Low levels of high-density lipoproteins cholesterol are independently associated with acute coronary heart disease in patients hospitalized for chest pain.
abstract: OBJECTIVE
  The role of high-density lipoproteins in the context of acute chest pain has not been well characterized. The objective of this study was to determine the relative contribution of lipid profile to the risk of acute coronary syndrome in patients admitted to a cardiology ward for chest pain.
  
  
  METHODS
  We included all consecutive admissions in a single cardiology department over a period of 10 months and 1-year follow-up was performed.
  
  
  RESULTS
  In total, 959 patients were included: 457 (47.7%) were diagnosed with non-ischemic chest pain, 355 (37%) with non-ST-elevation acute coronary syndrome, and 147 (15.3%) with ST-elevation acute coronary syndrome. Prevalence of high-density lipoproteins <40 mg/dL was 54.6%, and was higher in patients with acute coronary syndrome (69.4% vs 30.6%; P<.01). The prevalence of acute coronary syndrome increased with reductions in mean high-density lipoproteins. Age, active smoking, diabetes, fasting glucose >100 mg/dL, and high-density lipoproteins <40 mg/dL were independently associated with acute coronary syndrome, and low high-density lipoproteins was the main associated factor (odds ratio, 4.11; 95% confidence interval, 2.87-5.96). Survival analysis determined that, compared with non-ischemic chest pain, the presence of acute coronary syndrome was associated with significantly greater risk of all-cause and cardiovascular mortality.
  
  
  CONCLUSIONS
  Low levels of high-density lipoproteins cholesterol (≤40 mg/dL) were independently associated with a diagnosis of acute coronary syndrome in patients hospitalized for chest pain, with an inverse relationship between lower levels of high-density lipoproteins and prevalence of acute coronary syndrome.
authors: Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain. acorderofort@gmail.com
authors: Alberto
authors: A
authors: Cordero
authors: José
authors: J
authors: Moreno-Arribas
authors: Vicente
authors: V
authors: Bertomeu-González
authors: Pilar
authors: P
authors: Agudo
authors: Beatriz
authors: B
authors: Miralles
authors: M Dolores
authors: MD
authors: Masiá
authors: Ramón
authors: R
authors: López-Palop
authors: Vicente
authors: V
authors: Bertomeu-Martínez
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood* / Q000453:epidemiology* / Q000401:mortality; D008076:Cholesterol, HDL / Q000097:blood*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006760:Hospitalization; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008055:Lipids