Document Detail


HDL-cholesterol level provides additional prognosis in acute coronary syndromes.
MedLine Citation:
PMID:  18706714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the setting of acute coronary syndromes, plasma lipids have not been defined as prognostic variables, however little research has been dedicated to this specific issue. In order to test the independent predictive value for in-hospital events of low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol and triglycerides measured at hospital admission, 97 individuals with unstable angina or non-ST-elevation acute myocardial infarction were evaluated. In-hospital events, defined as death, non-fatal myocardial infarction or recurrent unstable angina, were significantly predicted by HDL-cholesterol (C-statistics=0.69; 95% CI=0.55-0.83, P=0.018), contrary to LDL-cholesterol (C-statistics=0.40; 95% CI=0.24-0.56, P=0.23) and triglycerides (C-statistics=0.48; 95% CI=0.31-0.65, P=0.83). The best HDL-cholesterol cut-off point was 32 mg/dl, with a 33% incidence of events in patients with HDL-cholesterol < or =32 mg/dl, compared with only 9% in those with HDL-cholesterol>32 mg/dl (P=0.003). Logistic regression analysis showed HDL-cholesterol< or =32 mg/dl (OR=3.6; 95% CI=1.0-14; P=0.05) and TIMI Risk Score (OR=2.3; 95% CI=1.4-2.9, P=0.001) as the independent predictors of events. Furthermore, the addition of HDL-cholesterol to TIMI Risk Score improved its C-statistic from 0.81 to 0.85. In conclusion, as opposed to LDL-cholesterol and triglycerides, HDL-cholesterol level adds prognostic value to the prediction of in-hospital recurrent events during non-ST-elevation acute coronary syndromes.
Authors:
Luís C L Correia; Mário S Rocha; J Péricles Esteves
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Publication Detail:
Type:  Journal Article     Date:  2008-08-15
Journal Detail:
Title:  International journal of cardiology     Volume:  136     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-04     Completed Date:  2009-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  307-14     Citation Subset:  IM    
Affiliation:
Portuguese Hospital, Salvador/BA, Brazil. lccorreia@terra.com.br
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / blood*,  diagnosis,  mortality*
Aged
Angina, Unstable / blood,  diagnosis,  mortality
Biological Markers / blood*
Cholesterol, HDL / blood*
Cholesterol, LDL / blood
Electrocardiography, Ambulatory
Female
Humans
Male
Middle Aged
Myocardial Infarction / blood,  diagnosis,  mortality
Myocardial Ischemia / blood,  diagnosis,  mortality
Predictive Value of Tests
Prognosis
Risk Factors
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Triglycerides

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