The effect of intensified low density lipoprotein cholesterol reduction on recurrent myocardial infarction and cardiovascular mortality

Wei Chun Huang, Tzu Wen Lin, Kuan Rau Chiou, Chin Chang Cheng, Feng Yu Kuo, Cheng Hung Chiang, Jin Shiou Yang, Ko Long Lin, Shin Hung Hsiao, Tong Chen Yeh, Guang Yuan Mar, Hsiang Chiang Hsiao, Shoa Lin Lin, Chuen Wang Chiou, Chun Peng Liu

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8 Citations (Scopus)

Abstract

Background: Lipid-lowering therapy plays an important role in preventing the recurrence of cardiovascular events in patients after acute myocardial infarction (AMI). This study aimed to assess the effect of intensified low density lipoprotein cholesterol (LDL-C) reduction on recurrent myocardial infarction and cardiovascular mortality in patients after AMI. Method: The 562 enrolled AMI patients (84.2% male) were divided into two groups according to 3-month LDL-C decrease percentage equal to or more than 40% (n = 165) and less than 40% (n = 397). To evaluate the long-term efficacy of LDL-C reduction, the 5-year outcomes were collected, including time to the first occurrence of myocardial infarction and time to cardiovascular death. Results: The baseline characteristics and complication rates were not different between the two study groups. The patients with 3-month LDL-C decrease≧ 40% had higher baseline LDL-C and lower 3-month, 1-year, 2-year, 3-year, 4-year and 5-year LDL-C than the patients with 3-month LDL-C decrease < 40%. In Kaplan-Meier analyses, those patients with 3-month LDL-C decrease ≧ 40% had a higher rate of freedom from myocardial infarction (p = 0.006) and survival rate (p = 0.02) at 5-year follow-up. The 3-month LDL-C < 40% parameter was significantly related to cardiovascular death (HR: 9.62, 95% CI 1.18-78.62, p < 0.04). Conclusions: After acute myocardial infarction, 3-month LDL-C decrease < 40% was identified to be a significant risk factor for predicting 5-year cardiovascular death. The patients with 3-month LDL-C decrease ≧ 40% had a higher rate of freedom from myocardial infarction and lower cardiovascular mortality, even though these patients had higher baseline LDL-C value.

Original languageEnglish
Pages (from-to)404-412
Number of pages9
JournalActa Cardiologica Sinica
Volume29
Issue number5
Publication statusPublished - Sep 1 2013
Externally publishedYes

Keywords

  • Acute myocardial infarction
  • Cardiovascular death
  • Low-density lipoprotein cholesterol
  • Mortality
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Huang, W. C., Lin, T. W., Chiou, K. R., Cheng, C. C., Kuo, F. Y., Chiang, C. H., Yang, J. S., Lin, K. L., Hsiao, S. H., Yeh, T. C., Mar, G. Y., Hsiao, H. C., Lin, S. L., Chiou, C. W., & Liu, C. P. (2013). The effect of intensified low density lipoprotein cholesterol reduction on recurrent myocardial infarction and cardiovascular mortality. Acta Cardiologica Sinica, 29(5), 404-412.