Lower Baseline LDL Cholesterol Affects All-cause Mortality in Patients with First Percutaneous Coronary Intervention.

Xi Chen; Hao Chen; Bo LU Wei; Min Zhang; Yuan Tao; Qing Cheng Wang; Guo Sheng FU; Wen Bin Zhang

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Lower Baseline LDL Cholesterol Affects All-cause Mortality in Patients with First Percutaneous Coronary Intervention.

Author: Xi CHEN ¹ ; Hao CHEN ^{2
,

3} ; Bo LU WEI ⁴ ; Min ZHANG ⁴ ; Yuan TAO ³ ; Qing Cheng WANG ⁵ ; Guo Sheng FU ⁶ ; Wen Bin ZHANG ⁶
Author Information

1. Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, School of the Second Clinical Medicine, Hangzhou Normal University, Hangzhou 310014, Zhejiang, China.
2. Department of Cardiovascular Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310020, Zhejiang, China
3. Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou 312499, Zhejiang, China.
4. Collaborative Innovation Center of Seafood Deep Processing, Zhejiang Province Joint Key Laboratory of Aquatic Products Processing, Institute of Seafood, Zhejiang Gongshang University, Hangzhou 310012, Zhejiang, China.
5. Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, Zhejiang, China.
6. Department of Cardiovascular Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310020, Zhejiang, China.
Publication Type:Journal Article
Keywords: Clinical outcomes; Coronary artery disease; Low-density lipoprotein cholesterol
MeSH: Humans; Cholesterol, LDL; Retrospective Studies; Percutaneous Coronary Intervention/adverse effects*; Coronary Artery Disease/surgery*; Cholesterol; Cholesterol, HDL; Stroke/etiology*; Treatment Outcome; Risk Factors
From: Biomedical and Environmental Sciences 2023;36(4):324-333
CountryChina
Language:English
Abstract: OBJECTIVE:Foreign studies have reported that coronary artery disease (CAD) patients with high baseline low-density lipoprotein cholesterol (LDL-C) may have a good prognosis, which is called the "cholesterol paradox". This study aimed to examine whether the "cholesterol paradox" also exists in the Chinese population.
METHODS:A total of 2,056 patients who underwent the first percutaneous coronary intervention (PCI) between 2014 and 2016 were enrolled in this retrospective cohort study and classiﬁed into two groups based on baseline LDL-C = 2.6 mmol/L (100 mg/dL). The outcomes of interest included major adverse cardiovascular events (MACE), all-cause mortality, recurrent nonfatal myocardial infarction, unexpected coronary revascularization, or any nonfatal stroke.
RESULTS:All-cause mortality occurred in 8 patients (0.7%) from the low-LDL-C group and 12 patients (2.4%) in the high-LDL-C group, with a significant difference between the two groups (adjusted hazard ratio: 4.030, 95% confidence interval: 1.088-14.934; P = 0.037). However, no signiﬁcant differences existed for the risk of MACE or other secondary endpoints, such as unexpected revascularization, nor any nonfatal stroke in the two groups.
CONCLUSION:In this study, a high baseline LDL-C was not associated with a low risk of clinical outcomes in CAD patients undergoing first PCI, which suggested that the "cholesterol paradox" may be inapplicable to Chinese populations.