Non-high-density lipoprotein cholesterol predicts nonfatal recurrent myocardial infarction in patients with ST segment elevation myocardial infarction

Lipids in Health and Disease

Research

Yang Zheng¹  Ming Gao¹  Weihua Zhang¹  Ling Qin¹  Lin Wang¹  Yi Cheng² 

[1] The Cardiovascular Center, First Hospital of Jilin University, 71 Xinmin Street, 130021, Changchun, China;The Cardiovascular Center, First Hospital of Jilin University, 71 Xinmin Street, 130021, Changchun, China;Laboratory for Cardiovascular Diseases, Institute of Translational Medicine, Changchun, China;Key Laboratory for Cardiovascular Mechanism of Traditional Chinese Medicine, First Hospital of Jilin University, 130021, Changchun, China;

关键词: Recurrent myocardial infarction;    ST segment elevation myocardial infarction;    Serum transaminase;    Primary percutaneous coronary intervention;    Lipid;   

DOI  :  10.1186/s12944-017-0418-5

 received in 2016-11-17, accepted in 2017-01-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLipids, which are associated with atherogenesis, clotting, and the fibrinolytic pathway, may be important prognostic indicators of recurrent myocardial infarction. The aim of this study was to determine the predictive value of baseline lipid fractions for nonfatal recurrent myocardial infarction in patients with ST segment elevation myocardial infarction 2 years after primary percutaneous coronary intervention in China.MethodsCox proportional-hazards models were used to evaluate the association between potential risk factors, including lipid fractions, and the occurrence of nonfatal recurrent myocardial infarction in 2402 consecutive patients who underwent primary percutaneous coronary intervention for ST segment elevation myocardial infarction.ResultsThe cumulative incidence of recurrent myocardial infarction was 2.7% at 1 year, 3.8% at 2 years, and 5.8% at 3 years after percutaneous coronary intervention. The effects of collinearity of lipids were investigated. In concerning the principal components analysis, composing factor 1 (scoring factors were 0.689 for non-HDL, 0.702 for LDL, 0.182 for HDL) which had eigenvalues of 1.86 and explained 62% of the variability among lipid cholesterols was significantly associated with recurrent MI in the final adjusted analysis of the lipid cholesterols principal components. Non-high-density lipoprotein cholesterol was the strongest independent predictor of nonfatal recurrent myocardial infarction. The adjusted hazards ratios for nonfatal recurrent myocardial infarction were 1.26 (95% confidence interval (CI): 1.05–1.51) for non-high-density lipoprotein cholesterol, 1.17 (95% CI: 0.99–1.39) for low-density lipoprotein and 1.15 (95% CI: 0.95–1.40) for HDL. After adjusting for gender and age, the odds ratio for patients in the highest non-high-density lipoprotein cholesterol quartile was 2.10 (95% CI: 1.19–3.72).ConclusionsNon-high-density lipoprotein cholesterol value is a stronger predictor of nonfatal recurrent myocardial infarction than other lipid risk factors in patients with ST segment elevation myocardial infarction. Moreover, the occurrence of reinfarction after percutaneous coronary intervention was highest for patients in the highest non-high-density lipoprotein cholesterol quartile.Trial registrationhttp://www.chictr.org.cn/edit.aspx?pid=13583&htm=4, registration number: ChiCTR-EPC-16008199, date of registration:2013.01.01.

【 授权许可】

CC BY   
© The Author(s). 2017