The Early Treatment Gap of Dyslipidemia for Patients With Acute Myocardial Infarction.
10.4070/kcj.2008.38.8.419
- Author:
Ho KIL
1
;
Eun Young CHOI
;
Won Yik LEE
;
Jang Whan BAE
;
Kyung Kuk WHANG
;
Dong Woon KIM
;
Myeong Chan CHO
Author Information
1. Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea. drcorazon@hanmail.net
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Dyslipidemia;
Treatment
- MeSH:
Dyslipidemias;
Follow-Up Studies;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Infarction;
Medical Records;
Myocardial Infarction;
Retrospective Studies;
ROC Curve;
Sensitivity and Specificity
- From:Korean Circulation Journal
2008;38(8):419-424
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: A treatment gap for dyslipidemia can occur during the early phase of acute myocardial infarction (AMI) because the baseline low density lipoprotein-cholesterol (LDL-C) level during this period rapidly decreases physiologically. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of the patients who were admitted with AMI from December 2004 to July 2007 and their baseline LDL-C levels were less than 100 mg/dL. We analyzed the baseline lipid profiles and its serial changes in these patients. The initial LDL-C value, which can be expected to increase to over 100 mg/dL of LDL-C after discharge, was estimated statistically. RESULTS: Among the 298 AMI patients, 94 (31.5%) patients showed a LDL-C level below 100 mg/dL. The LDL-C level increases between baseline and within 2 weeks, 2-6 weeks and 6 weeks after discharge were 11.8+/-22.5, 24.4+/-23.8 and 26.6+/-16.6 mg/dL, respectively. We made a receiver operating characteristics (ROC) curve of the LDL-C level at baseline and within 2 weeks after discharge for predicting the increment of the LDL-C level. Using the cutoff value 74 mg/dL for the initial LDL-C level, the sensitivity and specificity were 83% and 50%, respectively. With using an 81 mg/dL cutoff value at 2 weeks, the sensitivity and specificity were 83% and 62%, respectively. CONCLUSION: A significant portion of AMI patients with an LDL-C level less than 100 mg/dL and who were not prescribed statin in the early phase of infarction showed an elevated LDL-C level over 100 mg/dL at 2 weeks after the infarction. The early administration of statin should be considered for treating an LDL-C=74 mg/dL during the initial period of AMI or an LDL-C=81 mg/dL at 2 weeks after AMI because their LDL-C level will increase to over 100 mg/dL during the subsequent follow-up period.
