Document Detail

Change in serum lipids after acute coronary syndromes: secondary analysis of SPACE ROCKET study data and a comparative literature review.
MedLine Citation:
PMID:  20729301     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has long been an accepted belief that serum cholesterol significantly falls after myocardial infarction and that a return to pre-event levels takes approximately 3 months. The magnitude and clinical significance of this fall has recently been challenged. METHODS: In the Secondary Prevention of Acute Coronary Events-Reduction Of Cholesterol to Key European Targets (SPACE ROCKET) trial, we measured serum lipids of individuals on day 1 and between days 2 and 4 after acute myocardial infarction (AMI). Second, we performed a thorough literature review and compared all studies reporting data on absolute changes in lipids immediately after AMI, using weighted means. RESULTS: Of 1263 SPACE ROCKET participants, 128 had paired lipid measurements where both samples had been measured using identical methods at baseline and on days 2-4 after AMI. The mean lowering in total cholesterol between day 1 and day 2-4 was 0.71 mmol/L (95% CI 0.58-0.84; P < 0.0001) and in triglycerides was 0.10 mmol/L (-0.14-0.33; P = 0.405). A total of 25 papers showing absolute lipid changes post-AMI were identified. The combined data demonstrated a mean fall in total cholesterol of 9% to 11% from baseline over days 3-14 post-AMI, whereas for triglycerides, there was a rise of 18% from baseline to between day 9 and 12 weeks. CONCLUSIONS: After a secondary analysis of SPACE ROCKET data and a comparison of previously published data, we report a 10% fall in total cholesterol after AMI-a difference that is of high clinical significance. Consequently, measurement of serum lipids in patients with AMI should be performed within the first hours after presentation.
Julian H Barth; Beryl M Jackson; Amanda J Farrin; Maria Efthymiou; Gillian Worthy; Joanne Copeland; Kristian M Bailey; Simon P R Romaine; Anthony J Balmforth; Terry McCormack; Andrew Whitehead; Marcus D Flather; Jane Nixon; Alistair S Hall;
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-08-20
Journal Detail:
Title:  Clinical chemistry     Volume:  56     ISSN:  1530-8561     ISO Abbreviation:  Clin. Chem.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2010-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1592-8     Citation Subset:  IM    
Clinical Biochemistry, Leeds General Infirmary, Leeds, United Kingdom.
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MeSH Terms
Cholesterol / blood
Fluorobenzenes / therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Lipids / blood*
Multicenter Studies as Topic
Myocardial Infarction / blood*,  drug therapy
Pyrimidines / therapeutic use
Randomized Controlled Trials as Topic
Simvastatin / therapeutic use
Sulfonamides / therapeutic use
Triglycerides / blood
Reg. No./Substance:
0/Fluorobenzenes; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Lipids; 0/Pyrimidines; 0/Sulfonamides; 0/Triglycerides; 287714-41-4/rosuvastatin; 57-88-5/Cholesterol; 79902-63-9/Simvastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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