TY - JOUR
T1 - High high-density lipoprotein-cholesterol reduces risk and extent of percutaneous coronary intervention-related myocardial infarction and improves long-term outcome in patients undergoing elective percutaneous coronary intervention
AU - Sattler, Katherine J.E.
AU - Herrmann, Jörg
AU - Yün, Ehriban
AU - Lehmann, Nils
AU - Wang, Zhen
AU - Heusch, Gerd
AU - Sack, Stefan
AU - Erbel, Raimund
AU - Levkau, Bodo
N1 - Funding Information:
the Medtronic Fellowship Program to Z.W., and by grants from Deutsche Forschungsgemeinschaft [940/4-1, LE940/3-1] to B.L.
Funding Information:
This work was supported by a grant from Deutsche Gesellschaft für Kardiologie—Herz-und Kreislaufforschung e.V. to K.J.E.S., a grant from
PY - 2009/8
Y1 - 2009/8
N2 - AimsThe study tested whether high-density lipoprotein-cholesterol (HDL-C) has an effect on percutaneous coronary intervention (PCI)-induced myocardial infarction and its prognosis. Elevation of cardiac troponin I (cTnI) > 3× upper normal limit after PCI is defined as PCI-related myocardial infarction (PMI) and is associated with a negative prognosis. No data exist on the relationship of HDL-C to PMI and PMI-related outcome.Methods and resultsPre-procedural HDL-C levels and post-procedural peak cTnI levels were collected in 350 patients undergoing PCI. Data were analysed for PMI and for acute myocardial infarction (AMI) during follow-up. Patients with PMI (n = 115) had lower HDL-C levels than patients without PMI [n = 235; 1.17 mmol/L (0.75-2.51) vs. 1.27 mmol/L (0.70-2.87), P < 0.001]. Pre-procedural HDL-C levels were inversely related to the occurrence of PMI [odds ratio for PMI: 0.884, 95 CI: 0.80, 0.98; P = 0.02 for an HDL-C-increment of 5 mg/dL (0.13 mmol/L)] and to AMI during follow-up [hazard ratio (HR): 0.697, 95 CI: 0.54, 0.90; P = 0.005]. The occurrence of PMI was associated with an elevated HR for AMI (4.702, 95 CI: 1.79, 12.37; P = 0.002). Low-risk levels of pre-procedural HDL-C [men ≥40 mg/dL (≥1.03 mmol/L), women ≥45 mg/dL (≥1.16 mmol/L)] did not influence the negative effects of PMI on outcome (HR: 5.510, 95 CI: 1.43, 21.31; P = 0.013) and reduction of AMI-free survival [mean AMI-free survival time with PMI: 1167.5 days (95 CI: 1098.27, 1236.67) vs. 1240.7 days (95 CI: 1220.94, 1290.49) without PMI; log-rank P = 0.005].
AB - AimsThe study tested whether high-density lipoprotein-cholesterol (HDL-C) has an effect on percutaneous coronary intervention (PCI)-induced myocardial infarction and its prognosis. Elevation of cardiac troponin I (cTnI) > 3× upper normal limit after PCI is defined as PCI-related myocardial infarction (PMI) and is associated with a negative prognosis. No data exist on the relationship of HDL-C to PMI and PMI-related outcome.Methods and resultsPre-procedural HDL-C levels and post-procedural peak cTnI levels were collected in 350 patients undergoing PCI. Data were analysed for PMI and for acute myocardial infarction (AMI) during follow-up. Patients with PMI (n = 115) had lower HDL-C levels than patients without PMI [n = 235; 1.17 mmol/L (0.75-2.51) vs. 1.27 mmol/L (0.70-2.87), P < 0.001]. Pre-procedural HDL-C levels were inversely related to the occurrence of PMI [odds ratio for PMI: 0.884, 95 CI: 0.80, 0.98; P = 0.02 for an HDL-C-increment of 5 mg/dL (0.13 mmol/L)] and to AMI during follow-up [hazard ratio (HR): 0.697, 95 CI: 0.54, 0.90; P = 0.005]. The occurrence of PMI was associated with an elevated HR for AMI (4.702, 95 CI: 1.79, 12.37; P = 0.002). Low-risk levels of pre-procedural HDL-C [men ≥40 mg/dL (≥1.03 mmol/L), women ≥45 mg/dL (≥1.16 mmol/L)] did not influence the negative effects of PMI on outcome (HR: 5.510, 95 CI: 1.43, 21.31; P = 0.013) and reduction of AMI-free survival [mean AMI-free survival time with PMI: 1167.5 days (95 CI: 1098.27, 1236.67) vs. 1240.7 days (95 CI: 1220.94, 1290.49) without PMI; log-rank P = 0.005].
KW - Coronary artery disease
KW - High-density lipoprotein-cholesterol
KW - PCI-related myocardial infarction
KW - Prognosis
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U2 - 10.1093/eurheartj/ehp183
DO - 10.1093/eurheartj/ehp183
M3 - Article
C2 - 19474052
AN - SCOPUS:68749100860
SN - 0195-668X
VL - 30
SP - 1894
EP - 1902
JO - European heart journal
JF - European heart journal
IS - 15
ER -