【論文摘要】Clinical Outcomes According to the Achievement of Target Low-density Lipoprotein Cholesterol in Patients after ST-segment Elevation Myocardial Infarction

Wei-Chieh Lee

《海峽循環醫學雜誌》 1卷2S期 (2019/09) Pp. 152-152

https://doi.org/10.6907/SCJ.201909/SP_1(2).0125

摘要

Background/Synopsis: Lots of studies have reported that the risk of cardiovascular events decreases with low-density lipoprotein cholesterol (LDL-C) reduction, and the risk of recurrent cardiovascular events and survival improvement in patients with ST-segment elevation myocardial infarction (STEMI) is reduced by using statin. The clinical outcome of patient with STEMI undergoing primary percutaneous coronary intervention (PCI), with or without achievement of target LDL-C, has little known information. Lots of hyperlipidemia patients with STEMI in current practice do not attain the guideline-recommended target LDL-C level. In addition, the influence of the intensity of statin therapy as represented by the achieved level of LDL-C on cardiovascular outcomes in patients with STEMI has not been fully evaluated. Objectives/Purpose: This study was investigated the clinical outcome of STEMI patient if target LDL-C level (below 70 mg/dL and or ≥50% reduction) achieved one year later. Methods/Results: Between two groups, higher prevalence of left main coronary artery disease, smaller pre-PCI stenosis, and larger pre-PCI minimal luminal diameter were noted in group 2. The incidence of post-MI angina (8.7% vs. 6.4%; p=0.393), target vessel revascularization (2.3% vs. 3.5%; p=0.566), recurrent MI (1.5% vs. 1.2%; p=1.000), and major adverse cardiac event (3.2% vs. 4.1%; p=0.617) showed similar results between two groups during one-year follow-up period. Non-diabetes mellitus (DM), initial LDL-C level ≥ 130 mg/dL and left main coronary artery disease were positive associations of non-achievement of LDL-C target. Conclusion: After STEMI, 66.6% patients could be achieved LDL-C target one year later. However, such patients did not show better clinical outcomes. Non-DM, initial LDL-C level ≥ 130 mg/dL and left main coronary artery disease were related to non-achievement of LDL-C target.