Key result
Normal HDL-C links to lower in-hospital MACCE and one-year mortality in STEMI versus low HDL-C.
Why the study?
Low HDL-C is an established cardiovascular risk factor, but studies assessing the cardioprotective and prognostic impact of normal or high HDL-C in STEMI are lacking.
Does a normal initial serum HDL-C level (≥40 mg/dL) improve in-hospital MACCE and one-year all-cause mortality in patients presenting with STEMI compared to low HDL-C?
Does a normal initial serum HDL-C level (≥40 mg/dL) improve in-hospital MACCE and one-year all-cause mortality in patients presenting with STEMI compared to low HDL-C?
In patients presenting with STEMI, having a normal initial HDL-C level (≥40 mg/dL) is associated with significantly lower rates of in-hospital MACCE and one-year all-cause mortality compared to having low HDL-C.
Normal HDL-C may aid STEMI risk stratification; leaves open causality and need for prospective trials.
Low high-density lipoprotein-cholesterol (HDL-C) concentration is among the strongest independent risk factors for cardiovascular disease, however, studies to assess the cardioprotective effect of normal or high HDL-C level are lacking. To determine the prognostic impact of initial serum HDL-C level on in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) and the one-year all-cause mortality in patients presenting with ST-elevation myocardial infarction (STEMI) we performed a retrospective analysis of the data from 1,415 patients presenting with STEMI in a tertiary-care centre equipped with a 24-hour-ready catheterisation laboratory. The period from June 2014 to June 2017 was reviewed with a follow-up as regards one-year all-cause mortality. Patients were divided into two groups according to HDL-C level. HDL-C <40 mg/dL (2.22 mmol/L) was considered low, while HDL-C ≥40 mg/dL was considered normal. There were 1,109 patients with low HDL-C, while 306 had normal HDL-C levels, which was statistically significant (p<0.001). Total MACCE and all-cause mortality were significantly lower in patients with normal HDL-C (p=0.03 and p=0.01, respectively). In conclusion, this retrospective study to assess the prognostic effect of HDL-C in patients presenting with STEMI, found normal HDL-C level was associated with lower in-hospital MACCE and all-cause mortality at one-year follow-up.
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Amrawy et al. (2023) studied this question. Normal HDL-C levels (≥40 mg/dL) in patients with STEMI were associated with significantly lower in-hospital MACCE (p=0.03) and one-year all-cause mortality (p=0.01) compared to low HDL-C.
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