Author + information
- Haruki Sekiguchi,
- Erisa Kawada-Watanabe,
- Hiroyuki Arashi,
- Junichi Yamaguchi,
- Hiroshi Ogawa and
- Nobuhisa Hagiwara
Well-controlled low-density lipoprotein-cholesterol (LDL-C) levels are important for secondary prevention of coronary artery disease, particularly in the setting of acute coronary syndrome (ACS). However, the association between other conventional lipid measures and major cardiovascular adverse events (MACEs) in patients with ACS receiving aggressive lipid-lowering management for dyslipidemia is unknown. We aimed to compare the association between high-density lipoprotein-cholesterol (HDL-C), non-HDL-C, triglycerides (TG) and the LDL-C/HDL-C ratio and MACEs (a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina, or any coronary revascularization) in patients with ACS receiving lipid-lowering therapy.
This is a sub-analysis of the Heart Institute of Japan-PRoper level of lipid lOwering with Pitavastatin and Ezetimibe in acute coRonary syndrome (HIJ-PROPER) study, which assessed the influence of aggressive LDL-C lowering treatment using statin and ezetimibe in 1734 patients diagnosed with ACS and concomitant dyslipidemia. We performed a log rank analysis of MACEs using blood lipid profiles including HDL-C, non-HDL-C, TG, and the LDL-C/HDL-C ratio.
We studied 1721 patients (mean age 65 ± 12 years, men 75.5%) who were followed-up for 3 years and observed that 599 presented with MACEs. The low LDL-C/HDL-C ratio group (≤ 2.3) showed a significantly lower event rate than the other groups (p[A1] < 0.05). Other components of the lipid profile did not show a significant association with MACEs. Based on the receiver operating characteristic (ROC) curve analysis, the optimal cut-off level for the LDL-C/HDL-C ratio was determined to be 2.5 (sensitivity 67.4%, specificity 38.2%, area under curve 0.544).
Our sub-analysis of data obtained from the HIJ-PROPER study revealed that the LDL-C/HDL-C ratio as compared to other parameters was more strongly associated with MACEs in patients with ACS receiving aggressive lipid-lowering therapy.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 10:00 a.m.-10:45 a.m.
Session Title: The Latest on Dyslipidemia Care in the Age of Precision Medicine
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1129-405
- 2018 American College of Cardiology Foundation