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The Korean Journal of Medicine 2009;76(6): 692-700.
관상동맥 중재술을 받은 급성 심근경색증 환자의 저밀도 지단백 콜레스테롤 수치와 임상경과
조경훈, 정명호, 박근호, 이민구, 고점석, 이신은, 강원유, 김수현, 심두선, 윤남식, 윤현주, 홍영준, 박형욱, 김주한, 안영근, 조정관, 박종춘, 강정채
Relationship between the low-density lipoprotein cholesterol level and clinical outcome after percutaneous coronary intervention in patients with acute myocardial infarction
Kyung Hoon Cho, Myung Ho Jeong, Keun-Ho Park, Min Goo Lee, Jum Suk Ko, Shin Eun Lee, Won Yu Kang, Soo Hyun Kim, Doo Sun Sim, Nam Sik Yoon, Hyun Ju Youn, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
ABSTRACT
Background/Aims:
This study examined the relationship between the low-density lipoprotein cholesterol (LDL-C) level and clinical outcome after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).
Methods:
Between January 2006 and December 2007, 867 patients (age, 62.6±12.5 years; males, 71%) undergoing a 1-year follow-up after PCI for AMI were divided into five groups according to the LDL-C level: <70, 70-100, 100-130, 130-160, and ≥160mg/dL.
Results:
Smoking (63%), hypertension (46%), and diabetes mellitus (28%) were common risk factors. The history of ischemic heart disease decreased as the LDL-C level increased (p=0.036). Patients with lower LDL-C levels had lower creatinine clearance and higher high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. The rate of in-hospital complications after PCI declined with increases in the LDL-C level, except in patients with LDL-C >160 mg/dL (linear p=0.010). There was no correlation between the LDL-C level and the 30-day or 1-year clinical outcome after PCI. After multivariate adjustment, independent predictors of the 1-year mortality after PCI were left ventricular ejection fraction, hsCRP, age, and creatinine clearance.
Conclusions:
Higher LDL-C levels were related to fewer in-hospital complications, but there was no correlation between the LDL-C level and long-term clinical outcome after PCI in Korean patients with AMI.
Keywords: Myocardial infarction; Low-density lipoprotein cholesterol; Percutaneous coronary intervention
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