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Relationship of High-Density Lipoprotein Cholesterol With Periprocedural Myocardial Injury Following Elective Percutaneous Coronary Intervention in Patients With Low-Density Lipoprotein Cholesterol Below 70 mg/dL
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DOI：10.1161/JAHA.114.001412.png)
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Abstract
En 中文
Background-Recent data showed inconsistent association of high-density lipoprotein cholesterol (HDL-C) with cardiovascular risk in patients with different levels of low-density lipoprotein cholesterol (LDL-C) or intensive statin therapy. This study sought to determine the relationship of HDL-C with periprocedural myocardial injury following elective percutaneous coronary intervention (PCI) across a range of LDL-C levels, especially in patients with LDL-C <70 mg/dL. Methods and Results-We enrolled 2529 consecutive patients with normal preprocedural cardiac troponin I (cTnI) who underwent elective PCI. The association between preprocedural HDL-C and periprocedural myocardial injury was evaluated across LDL-C levels, especially in patients with LDL-C <70 mg/dL. The HDL-C level was not predictive of periprocedural myocardial injury across the entire study cohort. However, among patients with LDL-C <70 mg/dL, a 1 mg/dL increase in HDL-C was associated with a 3% reduced risk for postprocedural cTnI above 1xupper limit of normal (ULN) (odds ratio: 0.97; 95% CI: 0.95 to 0.99; P=0.004), a 3% reduced risk for postprocedural cTnI above 3xULN odds ratio: 0.97; 95% CI: 0.95 to 0.99; P=0.022), and a 3% reduced risk for postprocedural cTnI above 5xULN (odds ratio: 0.97; 95% CI: 0.95 to 0.99; P=0.017). The relation between plasma HDL-C level and risk of postprocedural cTnI elevation above 1xULN, 3xULN, and 5xULN was modified by LDL-C level (all P for interaction <0.05). Conclusions-Higher HDL-C levels were associated with reduced risk of periprocedural myocardial injury only in patients with LDL-C <70 mg/dL.
Keywords:
high-density lipoprotein cholesterol
low-density lipoprotein cholesterol
percutaneous coronary intervention
periprocedural myocardial injury
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