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Patterns and prognostic implications of low high-density lipoprotein levels in patients with non-ST-segment elevation acute coronary syndromes.
Eur Heart J. 2008 Oct; 29(20):2480-8.EH

Abstract

AIMS

The patterns and prognostic significance of low high-density lipoprotein (HDL) cholesterol levels have not been well characterized. We sought to determine the prevalence and prognostic significance of low HDL cholesterol levels in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS).

METHODS AND RESULTS

We evaluated HDL levels among NSTE ACS patients [ischaemic ECG (electrocardiogram) changes and/or positive cardiac markers] from the CRUSADE [Can Rapid Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC(American College of Cardiology)/AHA(American Heart Association) Guidelines] initiative treated at 555 US hospitals from January 2001 through June 2006. Clinical and angiographic characteristics, treatments, and in-hospital outcomes were analysed by categories of HDL levels measured during hospitalization. Among 93 263 NSTE ACS patients with HDL measurements, 16 854 (18.1%) had very low HDL levels (10-29 mg/dL), 32 185 (34.5%) had low HDL levels (30-39 mg/dL), 35 875 (38.5%) had normal HDL levels (40-59 mg/dL), and 8349 (9.0%) had high HDL levels (60-100 mg/dL). Patients with very low HDL levels were younger, more often male, and more commonly obese and diabetic. Patients with very low HDL levels had the greatest risk of multi-vessel coronary disease on angiography and in-hospital mortality compared with patients with normal and high HDL levels.

CONCLUSION

Almost one-fifth of patients with NSTE ACS have very low HDL levels--a finding that adds incrementally to a greater burden of atherosclerosis and a higher risk of mortality. Consequently, strategies for mitigating the adverse prognosis associated with very low HDL levels warrant further exploration in patients with ACS.

Authors+Show Affiliations

Department of Medicine, Division of Cardiovascular Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA. matthew.roe@duke.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18716006

Citation

Roe, Matthew T., et al. "Patterns and Prognostic Implications of Low High-density Lipoprotein Levels in Patients With non-ST-segment Elevation Acute Coronary Syndromes." European Heart Journal, vol. 29, no. 20, 2008, pp. 2480-8.
Roe MT, Ou FS, Alexander KP, et al. Patterns and prognostic implications of low high-density lipoprotein levels in patients with non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2008;29(20):2480-8.
Roe, M. T., Ou, F. S., Alexander, K. P., Newby, L. K., Foody, J. M., Gibler, W. B., Boden, W. E., Ohman, E. M., Smith, S. C., & Peterson, E. D. (2008). Patterns and prognostic implications of low high-density lipoprotein levels in patients with non-ST-segment elevation acute coronary syndromes. European Heart Journal, 29(20), 2480-8. https://doi.org/10.1093/eurheartj/ehn364
Roe MT, et al. Patterns and Prognostic Implications of Low High-density Lipoprotein Levels in Patients With non-ST-segment Elevation Acute Coronary Syndromes. Eur Heart J. 2008;29(20):2480-8. PubMed PMID: 18716006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns and prognostic implications of low high-density lipoprotein levels in patients with non-ST-segment elevation acute coronary syndromes. AU - Roe,Matthew T, AU - Ou,Fang-Shu, AU - Alexander,Karen P, AU - Newby,Laura Kristin, AU - Foody,Joanne M, AU - Gibler,W Brian, AU - Boden,William E, AU - Ohman,Erik Magnus, AU - Smith,Sidney C,Jr AU - Peterson,Eric D, Y1 - 2008/08/20/ PY - 2008/8/22/pubmed PY - 2009/1/31/medline PY - 2008/8/22/entrez SP - 2480 EP - 8 JF - European heart journal JO - Eur Heart J VL - 29 IS - 20 N2 - AIMS: The patterns and prognostic significance of low high-density lipoprotein (HDL) cholesterol levels have not been well characterized. We sought to determine the prevalence and prognostic significance of low HDL cholesterol levels in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). METHODS AND RESULTS: We evaluated HDL levels among NSTE ACS patients [ischaemic ECG (electrocardiogram) changes and/or positive cardiac markers] from the CRUSADE [Can Rapid Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC(American College of Cardiology)/AHA(American Heart Association) Guidelines] initiative treated at 555 US hospitals from January 2001 through June 2006. Clinical and angiographic characteristics, treatments, and in-hospital outcomes were analysed by categories of HDL levels measured during hospitalization. Among 93 263 NSTE ACS patients with HDL measurements, 16 854 (18.1%) had very low HDL levels (10-29 mg/dL), 32 185 (34.5%) had low HDL levels (30-39 mg/dL), 35 875 (38.5%) had normal HDL levels (40-59 mg/dL), and 8349 (9.0%) had high HDL levels (60-100 mg/dL). Patients with very low HDL levels were younger, more often male, and more commonly obese and diabetic. Patients with very low HDL levels had the greatest risk of multi-vessel coronary disease on angiography and in-hospital mortality compared with patients with normal and high HDL levels. CONCLUSION: Almost one-fifth of patients with NSTE ACS have very low HDL levels--a finding that adds incrementally to a greater burden of atherosclerosis and a higher risk of mortality. Consequently, strategies for mitigating the adverse prognosis associated with very low HDL levels warrant further exploration in patients with ACS. SN - 1522-9645 UR - https://www.unboundmedicine.com/medline/citation/18716006/Patterns_and_prognostic_implications_of_low_high_density_lipoprotein_levels_in_patients_with_non_ST_segment_elevation_acute_coronary_syndromes_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehn364 DB - PRIME DP - Unbound Medicine ER -