Relation Between Paradoxical Decrease in High-Density Lipoprotein Cholesterol Levels After Statin Therapy and Adverse Cardiovascular Events in Patients With Acute Myocardial Infarction

被引:9
|
作者
Ota, Tomoyuki [1 ]
Ishii, Hideki [1 ]
Suzuki, Susumu [1 ]
Tanaka, Akihito [1 ]
Shibata, Yohei [1 ]
Tatami, Yosuke [1 ]
Harata, Shingo [1 ]
Shimbo, Yusaku [1 ]
Takayama, Yohei [1 ]
Kawamura, Yoshihiro [1 ]
Osugi, Naohiro [1 ]
Maeda, Kengo [1 ]
Kondo, Takahisa [1 ]
Murohara, Toyoaki [1 ]
机构
[1] Nagoya Univ, Grad Sch Med, Dept Cardiol, Nagoya, Aichi, Japan
来源
AMERICAN JOURNAL OF CARDIOLOGY | 2015年 / 115卷 / 04期
关键词
INTIMA-MEDIA THICKNESS; CORONARY-HEART-DISEASE; HDL CHOLESTEROL; RISK; STROKE; DYSLIPIDEMIA; IMPACT; ATHEROSCLEROSIS; PREDICTOR; MORTALITY;
D O I
10.1016/j.amjcard.2014.11.043
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Statin therapy moderately increases high-density lipoprotein cholesterol (HDL-C) levels. Contrary to this expectation, a paradoxical decrease in HDL-C levels after statin therapy is seen in some patients. We evaluated 724 patients who newly started treatment with statins after acute myocardial infarction (AMI). These patients were divided into 2 groups according to change in HDL-C levels between baseline and 6 to 9 months after initial AMI (Delta HDL). In total, 620 patients had increased HDL-C levels and 104 patients had decreased HDL-C levels. Both groups achieved follow-up low-density lipoprotein cholesterol levels <100 mg/dl. Adverse cardiovascular events (a composite of all-cause death, myocardial infarction, and stroke) have more frequently occurred in the decreased HDL group compared with the increased HDL group (15.4% vs 7.1%, p = 0.01). Multivariate analysis showed that decreased HDL, onset to balloon time, and multivessel disease were the independent predictors of adverse cardiovascular events (hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.08 to 3.52; HR 1.05, 95% CI 1.01 to 1.09; and HR 2.08, 95% CI 1.22 to 3.56, respectively). In conclusion, a paradoxical decrease in serum HDL-C levels after statin therapy might be an independent predictor of long-term adverse cardiovascular events in patients with AMI. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:411 / 416
页数:6
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