title: Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus.
abstract: BACKGROUND
  It is still unclear whether low high-density lipoprotein cholesterol (HDL-C) affects cardiovascular outcomes after acute myocardial infarction (AMI), especially in patients with diabetes mellitus.
  
  
  METHODS
  A total of 984 AMI patients with diabetes mellitus from the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry were divided into two groups based on HDL-C level on admission: normal HDL-C group (HDL-C ≥ 40 mg/dL, n = 519) and low HDL-C group (HDL-C < 40 mg/dL, n = 465). The primary endpoint was 2-year major adverse cardiovascular events (MACE), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target vessel revascularization (TVR).
  
  
  RESULTS
  The median follow-up duration was 730 days. The 2-year MACE rates were significantly higher in the low HDL-C group than in the normal HDL-C group (MACE, 7.44% vs. 3.49%, p = 0.006; cardiac death, 3.72% vs. 0.97%, p = 0.004; non-fatal MI, 1.75% vs. 1.55%, p = 0.806; TVR, 3.50% vs. 0.97%, p = 0.007). Kaplan-Meier analysis revealed that the low HDL-C group had a significantly higher incidence of MACE compared to the normal HDL-C group (log-rank p = 0.013). After adjusting for conventional risk factors, Cox proportional hazards analysis suggested that low HDL-C was an independent risk predictor for MACE (hazard ratio [HR] 3.075, 95% confidence interval [CI] 1.034-9.144, p = 0.043).
  
  
  CONCLUSIONS
  In patients with diabetes mellitus, low HDL-C remained an independent risk predictor for MACE after adjusting for multiple risk factors during 2-year follow-up of AMI.
  
  
  BACKGROUND
  This study was the sub-analysis of the prospective multi-center registry of DIAMOND (Diabetic acute myocardial infarction Disease) in Korea. This is the observational study supported by Bayer HealthCare, Korea. Study number is 15614. First patient first visit was 02 April 2010 and last patient last visit was 09 December 2013.
authors.affiliation: Division of Cardiology, Korea University Anam Hospital, 126-1, 5 ka, Anam-dong, Sungbuk-ku, Seoul, 136-705, Republic of Korea.
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Joo
authors.affiliation: Division of Cardiology, Korea University Anam Hospital, 126-1, 5 ka, Anam-dong, Sungbuk-ku, Seoul, 136-705, Republic of Korea.
authors.forename: Sang-A
authors.initials: SA
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Korea University Anam Hospital, 126-1, 5 ka, Anam-dong, Sungbuk-ku, Seoul, 136-705, Republic of Korea.
authors.forename: Soon Jun
authors.initials: SJ
authors.lastname: Hong
authors.affiliation: Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Division of Cardiology, Konyang University Hospital, Daejeon, South Korea.
authors.forename: Jang-Ho
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Young-Keun
authors.initials: YK
authors.lastname: Ahn
authors.affiliation: Division of Cardiology, Yeungnam University Hospital, Daegu, South Korea.
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, South Korea.
authors.forename: Rak-Kyeong
authors.initials: RK
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Yonsei University Severance Hospital, Seoul, South Korea.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Joon-Hong
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea.
authors.forename: Kyoo-Rok
authors.initials: KR
authors.lastname: Han
authors.affiliation: Division of Cardiology, Kyungpook National University Hospital, Daegu, South Korea.
authors.forename: Hun-Sik
authors.initials: HS
authors.lastname: Park
authors.affiliation: Division of Cardiology, Ajou University Hospital, Suwon, South Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Wonju Severance Christian Hospital, Wonju, South Korea.
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Division of Cardiology, Samsung Medical Center, Seoul, South Korea.
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Kwon
authors.affiliation: Division of Cardiology, Korea University Guro Hospital, Seoul, South Korea.
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Division of Cardiology, Chungbuk National University Hospital, Cheongju, South Korea.
authors.forename: Kyung-Kuk
authors.initials: KK
authors.lastname: Hwang
authors.affiliation: Division of Cardiology, Eulji University Hospital, Daejeon, South Korea.
authors.forename: Kyung-Tae
authors.initials: KT
authors.lastname: Jung
authors.affiliation: Division of Cardiology, Wonkwang University Hospital, Iksan, South Korea.
authors.forename: Seok-Kyu
authors.initials: SK
authors.lastname: Oh
authors.affiliation: Division of Cardiology, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Ulsan University Hospital, Ulsan, South Korea.
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Daegu Catholic University Medical Center, Daegu, South Korea.
authors.forename: Kee-Sik
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Seoul National University Hospital, 101, DaeHak-ro, JongRo-gu, Seoul, 110-744, Republic of Korea. hyosoo@snu.ac.kr.
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Korea University Anam Hospital, 126-1, 5 ka, Anam-dong, Sungbuk-ku, Seoul, 136-705, Republic of Korea. dslmd@kumc.or.kr.
authors.forename: Do-Sun
authors.initials: DS
authors.lastname: Lim
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D048909:Diabetes Complications / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D008076:Cholesterol, HDL
keywords: Acute myocardial infarction; Diabetes mellitus; High-density lipoprotein cholesterol; Major adverse cardiovascular events