| Relationship between low-density lipoprotein cholesterol level on admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction, with or without diabetes, treated with percutaneous coronary intervention. | |
| | |
MedLine Citation:
|
PMID: 20859890 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) is the independent risk factor for coronary artery disease. Diabetes mellitus (DM) is associated with poor outcome in patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary interventions (PCI). The relationship between LDL-C and mortality in patients with STEMI has not been well established. AIM: To assess whether the LDL-C level on admission can predict in-hospital mortality in patients with or without DM treated with PCI for STEMI. METHODS: 1808 consecutive patients with STEMI (378 with DM) treated with PCI were included in the analysis. Patients were divided according to the presence of DM and LDL-C level on admission with a threshold of 3.7 mmol/L (143 mg/dL). In the diabetic group there were 208 patients with LDL-C〈 3.7 mmol/L (143 mg/dL) and 170 with LDL-C ≥ 3.7 mmol/L (143 mg/dL), whereas in the non-diabetic group 726 and 704 patients, respectively. We analysed the effects of LDL-C level and various risk factors on in-hospital mortality separately for patients with or without DM. RESULTS: The mean total cholesterol (5.6 ± 1.4 vs 5.7 ± 1.5 mmol/L; 216.6 ± 54.1 vs 220.4 ± 58 mg/dL, p = 0.21), LDL-C (3.6 ± 1.3 vs 3.7 ± 1.5 mmol/L; 139.2 ± 50.3 vs 143.0 ± 58 mg/dL, p = 0.11) and triglyceride level (1.7 ± 0.6 vs 1.6 ± 0.5 mmol/L; 150 ± 52.9 vs 141.2 ± 44.1 mg/dL, p = 0.30) were similar in patients with or without DM, whereas HDL-C level was lower in diabetic patients (1.4 ± 0.6 vs 1.8 ± 0.5 mmol/L; 53.7 ± 23.0 vs 69 ± 19.2 mg/dL, p = 0.049). The in-hospital mortality was 6.1% and 3.2%, for patients with or without DM, respectively (p = 0.008). In the diabetic group in-hospital mortality was higher in patients with LDL-C level on admission ≥ 3.7 mmol/L (143 mg/dL) in comparison to the patients with LDL-C〈 3.7 mmol/L (143 mg/dL; 7.1% vs 4.8%; p = 0.03). The multivariate analysis revealed that in diabetics an increase in LDL-C level on admission by 1 mmol/L (38.67 mg/dL) was related to a 45% increase in in-hospital mortality (OR 1.45, 95% CI 1.10-2.00, p = 0.023). In the non-diabetic group in-hospital mortality was similar in patients with LDL-C level on admission ≥ 3.7 mmol/L (143 mg/dL) and〈 3.7 mmol/L (143 mg/dL); 2.6% vs 3.7%; p = 0.21. In multivariate analysis LDL-C level was not related with in-hospital mortality in patients without DM (per 1 mmol/L; 38.67 mg/dL); OR 0.95, 95% CI 0.70-1.27, p = 0.71. CONCLUSIONS: Elevated LDL-C level on admission is associated with increased in-hospital mortality in diabetic but not in non-diabetic patients treated with PCI for STEMI. |
| | |
Authors:
|
Damian Pres; Mariusz Gasior; Andrzej Lekston; Marek Gierlotka; Michał Hawranek; Mateusz Tajstra; Piotr Buchta; Grzegorz Słonka; Lech Poloński |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Kardiologia polska Volume: 68 ISSN: 0022-9032 ISO Abbreviation: Kardiol Pol Publication Date: 2010 Sep |
Date Detail:
|
Created Date: 2010-09-22 Completed Date: 2010-12-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0376352 Medline TA: Kardiol Pol Country: Poland |
Other Details:
|
Languages: eng Pagination: 1005-12 Citation Subset: IM |
Affiliation:
|
Department of Cardiology, Silesian Medical University, Silesian Centre for Heart Diseases, Zabrze, Poland. damianpres@wp.pl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Angioplasty, Balloon, Coronary / mortality* Cholesterol, LDL / blood* Comorbidity Diabetes Mellitus, Type 2 / epidemiology*, prevention & control Female Hospital Mortality / trends* Humans Hypercholesterolemia / epidemiology* Incidence Male Middle Aged Multivariate Analysis Myocardial Infarction / metabolism, mortality*, therapy* Patient Admission / statistics & numerical data Poland / epidemiology Predictive Value of Tests Prognosis Retrospective Studies Risk Factors |
| Chemical | |
Reg. No./Substance:
|
0/Cholesterol, LDL |
| Comments/Corrections | |
Comment In:
|
Kardiol Pol. 2010 Sep;68(9):1013-4
[PMID:
20859891
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Peripheral blood concentrations of TGF?1, IGF-1 and bFGF and remodelling of the left ventricle and b...
Next Document: Oral versus intravenous hydration and renal function in diabetic patients undergoing percutaneous co...