Clinical Outcomes according to the Achievement of Target Low Density Lipoprotein-Cholesterol in Patients with Acute Myocardial Infarction.
OBJECTIVE
The clinical outcome of patient with an acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), with or without achievement of target low density lipoprotein-cholesterol (LDL-C), has little known information. This study investigated if target LDL-C level (below 70 mg/dL) achievements in patients with AMI showed better clinical outcomes or not.


METHODS
Between May 2008 and September 2012, this study enrolled 13473 AMI patients in a large-scale, prospective, multicenter Korean Myocardial Infarction (KorMI) registry. 12720 patients survived and 6746 patients completed a 1-year clinical follow up. Among them 3315 patients received serial lipid profile follow-ups. Propensity score matching was applied to adjust for differences in clinical baseline and angiographic characteristics, producing a total of 1292 patients (646 target LDL-C achievers vs. 646 non-achievers). The primary end point was the composite of a 1-year major adverse cardiac event (MACE) including cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR) and coronary artery bypass grafting.


RESULTS
After propensity score matching, baseline clinical and angiographic characteristics were similar between the two groups. Clinical outcomes of the propensity score matched patients who showed no significant differences in cardiac death (0.5% vs. 0.5%, p=1.000), recurrent MI (1.1% vs. 0.8%, p=0.562), TLR (5.0% vs. 4.5%, p=0.649), MACEs (6.5% vs. 5.9%, p=0.644) and stent thrombosis (2.5% vs. 1.9%, p=0.560).


CONCLUSIONS
In this propensity-matched comparison, AMI patients undergoing PCI with a target LDL-C (below 70 mg/dL) achievement did not show better clinical outcomes.
Gachon University Gil Hospital, Incheon, Korea.
Taehoon
T
Ahn
Gachon University Gil Hospital, Incheon, Korea.
Soon Yong
SY
Suh
Gachon University Gil Hospital, Incheon, Korea.
Kyounghoon
K
Lee
Gachon University Gil Hospital, Incheon, Korea.
Woong Chol
WC
Kang
Gachon University Gil Hospital, Incheon, Korea.
Seung Hwan
SH
Han
Chonnam National University Hospital, Gwangju, Korea.
Youngkeun
Y
Ahn
Chonnam National University Hospital, Gwangju, Korea.
Myung Ho
MH
Jeong
Low density lipoprotein-cholesterol; Myocardial infarction; Treatment outcome