title: Lowered postoperative ldl-c/hdl-C ratio reduces later cardiovascular events after abdominal aortic aneurysm surgery.
abstract: OBJECTIVE
  To examine the relationship between the incidence of later cardiovascular events after abdominal aortic aneurysm (AAA) surgery and postoperative lipid levels.
  
  
  METHODS
  Atherosclerotic risk factors including postoperative serum lipid levels were examined in 116 patients aged 70 or less undergoing an elective AAA surgery. Later cardiovascular events after AAA surgery occurred in 21 patients, including cerebral infarction (n = 4), catheter intervention or surgery for coronary artery disease (CAD) (n = 10) and other vascular disease.
  
  
  RESULTS
  Postoperative cholesterol levels during the average follow-up period of 55.6 ± 44.3 (months) were 49.0 ± 15.7 (mg/dL) for high-density lipoprotein cholesterol (HDL-C), 97.9 ± 31.2 (mg/dL) for low-density lipoprotein cholesterol (LDL-C), which were both significantly improved compared to preoperative values (p <0.001). Cox hazard analysis indicated that preexistent CAD significantly increased in the risk for later cardiovascular events (hazard ratio 5.67; 95%CI 1.92-16.8; p = 0.002) and lowered postoperative LDL-C/HDL-C ratio <1.5 decreased in the risk after AAA surgery (hazard ratio 0.10; 95%CI 0.01-0.83; p = 0.033). Patients with postoperative LDL-C/HDL-C ratio <1.5 (n = 22) had a significantly better cardiovascular event-free rate than those with that ratio ≥1.5 (n = 94) (p = 0.014).
  
  
  CONCLUSIONS
  Lowered postoperative LDL-C/HDL-C ratio <1.5 can decrease in the risk for later cardiovascular events after AAA surgery. These results may support the rationale for postoperative aggressive lipid-modifying therapy.
authors.affiliation: Division of Cardiovascular Surgery, Aishin Memorial Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kanaoka
authors.forename: Junichiro
authors.initials: J
authors.lastname: Takahashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Wakamatsu
authors.forename: Kouji
authors.initials: K
authors.lastname: Ishii
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Gohda
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Sasaki
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsui
keywords: abdominal aortic aneurysm; cardiovascular events; cholesterol; dyslipidemia; lipid-modifying therapy
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