title: Roles of High-Density Lipoprotein Cholesterol in Patients With Acute Myocardial Infarction.
abstract: Many observational studies showed hogh-density lipoprotein cholesterol (HDL-C) is a strong inverse predictor of cardiovascular (CV) outcome. However, recent large clinical trials evaluating therapies to raise HDL-C level in those already on statin therapy have been discouraging. This complexity is not well-known.A total of 28,357 acute myocardial infarction (AMI) patients were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR), which was a prospective, multicenter, nationwide, web-based database of AMI in Korea. From this registry, we evaluated 3574 patients with AMI who have follow-up HDL-C level to investigate its association with clinical outcomes. The primary endpoint was the relationship between follow-up change in HDL-C and a 12-month composite of major adverse cardiac events (MACEs).Patients with initial HDL-C ≥ 40 mg/dL showed significantly lower rates of 12-month MACEs, especially cardiac and all-cause mortalities (P < 0.001). When patients were stratified into 4 groups according to the change of HDL-C, patients with decreasing HDL-C showed significantly higher rates of 12-month MACEs as comparable with patients with increasing HLD-C. A multivariate analysis indicated that HDL-C level was a significant predictor of CV events (hazard ratio, 1.38; 95% confidence interval, 1.12-1.71) after correcting for confounding variables.The follow-up change in HDL-C level was significantly related with CV outcomes in patients with AMI.
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul (CHL, JSW, CBP, JMC, JK, WK); Department of Medicine, Division of Cardiology, Chonnam National University Hospital, Gwangju, Korea (YKA, MHJ).
authors.forename: Cheol Hyun
authors.initials: CH
authors.lastname: Lee
authors.forename: Jong Shin
authors.initials: JS
authors.lastname: Woo
authors.forename: Chang Bum
authors.initials: CB
authors.lastname: Park
authors.forename: Jin Man
authors.initials: JM
authors.lastname: Cho
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D017063:Outcome Assessment, Health Care; D065840:Protective Factors; D012008:Recurrence; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL