Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention
Abstract Introduction Hypercholesterolemia is a well-known risk factor for developing atherosclerosis and subsequently for the risk of a myocardial infarction (MI). Moreover, it might also be related to the extent of damaged myocardium in the event of a MI. The aim of this study was to evaluate the...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2019-02-01
|
| Series: | Cardiology and Therapy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1007/s40119-019-0126-5 |
| _version_ | 1818251318239690752 |
|---|---|
| author | Mathijs C. Bodde Maaike P. J. Hermans Ron Wolterbeek Christa M. Cobbaert Arnoud van der Laarse Martin J. Schalij J. Wouter Jukema |
| author_facet | Mathijs C. Bodde Maaike P. J. Hermans Ron Wolterbeek Christa M. Cobbaert Arnoud van der Laarse Martin J. Schalij J. Wouter Jukema |
| author_sort | Mathijs C. Bodde |
| collection | DOAJ |
| description | Abstract Introduction Hypercholesterolemia is a well-known risk factor for developing atherosclerosis and subsequently for the risk of a myocardial infarction (MI). Moreover, it might also be related to the extent of damaged myocardium in the event of a MI. The aim of this study was to evaluate the association of baseline low density lipoprotein-cholesterol (LDL-c) level with infarct size in patients with ST-segment elevation myocardial infarction (STEMI) after primary percutaneously coronary intervention (pPCI). Methods Baseline blood samples were obtained from all patients admitted between 2004 and 2014 with STEMI who underwent pPCI. Patients were excluded in case of out of hospital cardiac arrest, treatment delay of at least 10 h or no complete reperfusion after pPCI in the culprit vessel. Peak creatine kinase (CK) level was used for infarct size estimation, defined as the maximal value during admission. Results A total of 2248 patients were included in this study (mean age 61.8 ± 12.2 years; 25.0% female). Mean LDL-c level was 3.6 ± 1.1 mmol/L and median peak CK level was 1275 U/L (IQR 564–2590 U/L). Baseline LDL-c level [β = 0.041; (95% CI 0.019–0.062); p < 0.001] was independently associated with peak CK level. Furthermore, left anterior descending artery as culprit vessel, initial TIMI 0–1 flow in the culprit vessel, male gender, and treatment delay were also correlated with high peak CK level (p < 0.05). Prior aspirin therapy was associated with lower peak CK level [β = − 0.073 (95% CI − 0.146 to 0.000), p = 0.050]. Conclusion This study demonstrates that besides the more established predictors of infarct size, elevated LDL-c is associated with augmented infarct size in patients with STEMI treated with pPCI. |
| first_indexed | 2024-12-12T16:06:22Z |
| format | Article |
| id | doaj.art-92965af417974c528705fb80f9ef6070 |
| institution | Directory Open Access Journal |
| issn | 2193-8261 2193-6544 |
| language | English |
| last_indexed | 2024-12-12T16:06:22Z |
| publishDate | 2019-02-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Cardiology and Therapy |
| spelling | doaj.art-92965af417974c528705fb80f9ef60702022-12-22T00:19:17ZengAdis, Springer HealthcareCardiology and Therapy2193-82612193-65442019-02-0181556710.1007/s40119-019-0126-5Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary InterventionMathijs C. Bodde0Maaike P. J. Hermans1Ron Wolterbeek2Christa M. Cobbaert3Arnoud van der Laarse4Martin J. Schalij5J. Wouter Jukema6Department of Cardiology, Leiden University Medical CenterDepartment of Cardiology, Leiden University Medical CenterDepartment of Medical Statistics and Bioinformatics, Leiden University Medical CenterDepartment of Clinical Chemistry & Laboratory Medicine, Leiden University Medical CenterDepartment of Cardiology, Leiden University Medical CenterDepartment of Cardiology, Leiden University Medical CenterDepartment of Cardiology, Leiden University Medical CenterAbstract Introduction Hypercholesterolemia is a well-known risk factor for developing atherosclerosis and subsequently for the risk of a myocardial infarction (MI). Moreover, it might also be related to the extent of damaged myocardium in the event of a MI. The aim of this study was to evaluate the association of baseline low density lipoprotein-cholesterol (LDL-c) level with infarct size in patients with ST-segment elevation myocardial infarction (STEMI) after primary percutaneously coronary intervention (pPCI). Methods Baseline blood samples were obtained from all patients admitted between 2004 and 2014 with STEMI who underwent pPCI. Patients were excluded in case of out of hospital cardiac arrest, treatment delay of at least 10 h or no complete reperfusion after pPCI in the culprit vessel. Peak creatine kinase (CK) level was used for infarct size estimation, defined as the maximal value during admission. Results A total of 2248 patients were included in this study (mean age 61.8 ± 12.2 years; 25.0% female). Mean LDL-c level was 3.6 ± 1.1 mmol/L and median peak CK level was 1275 U/L (IQR 564–2590 U/L). Baseline LDL-c level [β = 0.041; (95% CI 0.019–0.062); p < 0.001] was independently associated with peak CK level. Furthermore, left anterior descending artery as culprit vessel, initial TIMI 0–1 flow in the culprit vessel, male gender, and treatment delay were also correlated with high peak CK level (p < 0.05). Prior aspirin therapy was associated with lower peak CK level [β = − 0.073 (95% CI − 0.146 to 0.000), p = 0.050]. Conclusion This study demonstrates that besides the more established predictors of infarct size, elevated LDL-c is associated with augmented infarct size in patients with STEMI treated with pPCI.http://link.springer.com/article/10.1007/s40119-019-0126-5LDL-cholesterolMyocardial infarct sizePrimary percutaneously coronary interventionST-segment elevation myocardial infarction |
| spellingShingle | Mathijs C. Bodde Maaike P. J. Hermans Ron Wolterbeek Christa M. Cobbaert Arnoud van der Laarse Martin J. Schalij J. Wouter Jukema Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention Cardiology and Therapy LDL-cholesterol Myocardial infarct size Primary percutaneously coronary intervention ST-segment elevation myocardial infarction |
| title | Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention |
| title_full | Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention |
| title_fullStr | Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention |
| title_full_unstemmed | Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention |
| title_short | Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention |
| title_sort | plasma ldl cholesterol level at admission is independently associated with infarct size in patients with st segment elevation myocardial infarction treated with primary percutaneous coronary intervention |
| topic | LDL-cholesterol Myocardial infarct size Primary percutaneously coronary intervention ST-segment elevation myocardial infarction |
| url | http://link.springer.com/article/10.1007/s40119-019-0126-5 |
| work_keys_str_mv | AT mathijscbodde plasmaldlcholesterollevelatadmissionisindependentlyassociatedwithinfarctsizeinpatientswithstsegmentelevationmyocardialinfarctiontreatedwithprimarypercutaneouscoronaryintervention AT maaikepjhermans plasmaldlcholesterollevelatadmissionisindependentlyassociatedwithinfarctsizeinpatientswithstsegmentelevationmyocardialinfarctiontreatedwithprimarypercutaneouscoronaryintervention AT ronwolterbeek plasmaldlcholesterollevelatadmissionisindependentlyassociatedwithinfarctsizeinpatientswithstsegmentelevationmyocardialinfarctiontreatedwithprimarypercutaneouscoronaryintervention AT christamcobbaert plasmaldlcholesterollevelatadmissionisindependentlyassociatedwithinfarctsizeinpatientswithstsegmentelevationmyocardialinfarctiontreatedwithprimarypercutaneouscoronaryintervention AT arnoudvanderlaarse plasmaldlcholesterollevelatadmissionisindependentlyassociatedwithinfarctsizeinpatientswithstsegmentelevationmyocardialinfarctiontreatedwithprimarypercutaneouscoronaryintervention AT martinjschalij plasmaldlcholesterollevelatadmissionisindependentlyassociatedwithinfarctsizeinpatientswithstsegmentelevationmyocardialinfarctiontreatedwithprimarypercutaneouscoronaryintervention AT jwouterjukema plasmaldlcholesterollevelatadmissionisindependentlyassociatedwithinfarctsizeinpatientswithstsegmentelevationmyocardialinfarctiontreatedwithprimarypercutaneouscoronaryintervention |