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. 2017 Jan 23;16(1):20.
doi: 10.1186/s12944-017-0418-5.

Non-high-density lipoprotein cholesterol predicts nonfatal recurrent myocardial infarction in patients with ST segment elevation myocardial infarction

Ming Gao  1 , Yang Zheng  1 , Weihua Zhang  1 , Yi Cheng  1   2   3 , Lin Wang  1 , Ling Qin  4
Affiliations

Non-high-density lipoprotein cholesterol predicts nonfatal recurrent myocardial infarction in patients with ST segment elevation myocardial infarction

Ming Gao et al. Lipids Health Dis. .

Abstract

Background: Lipids, which are associated with atherogenesis, clotting, and the fibrinolytic pathway, may be important prognostic indicators of recurrent myocardial infarction. The aim of this study was to determine the predictive value of baseline lipid fractions for nonfatal recurrent myocardial infarction in patients with ST segment elevation myocardial infarction 2 years after primary percutaneous coronary intervention in China.

Methods: Cox proportional-hazards models were used to evaluate the association between potential risk factors, including lipid fractions, and the occurrence of nonfatal recurrent myocardial infarction in 2402 consecutive patients who underwent primary percutaneous coronary intervention for ST segment elevation myocardial infarction.

Results: The cumulative incidence of recurrent myocardial infarction was 2.7% at 1 year, 3.8% at 2 years, and 5.8% at 3 years after percutaneous coronary intervention. The effects of collinearity of lipids were investigated. In concerning the principal components analysis, composing factor 1 (scoring factors were 0.689 for non-HDL, 0.702 for LDL, 0.182 for HDL) which had eigenvalues of 1.86 and explained 62% of the variability among lipid cholesterols was significantly associated with recurrent MI in the final adjusted analysis of the lipid cholesterols principal components. Non-high-density lipoprotein cholesterol was the strongest independent predictor of nonfatal recurrent myocardial infarction. The adjusted hazards ratios for nonfatal recurrent myocardial infarction were 1.26 (95% confidence interval (CI): 1.05-1.51) for non-high-density lipoprotein cholesterol, 1.17 (95% CI: 0.99-1.39) for low-density lipoprotein and 1.15 (95% CI: 0.95-1.40) for HDL. After adjusting for gender and age, the odds ratio for patients in the highest non-high-density lipoprotein cholesterol quartile was 2.10 (95% CI: 1.19-3.72).

Conclusions: Non-high-density lipoprotein cholesterol value is a stronger predictor of nonfatal recurrent myocardial infarction than other lipid risk factors in patients with ST segment elevation myocardial infarction. Moreover, the occurrence of reinfarction after percutaneous coronary intervention was highest for patients in the highest non-high-density lipoprotein cholesterol quartile.

Trial registration: http://www.chictr.org.cn/edit.aspx?pid=13583&htm=4 , registration number: ChiCTR-EPC-16008199, date of registration:2013.01.01.

Keywords: Lipid; Primary percutaneous coronary intervention; Recurrent myocardial infarction; ST segment elevation myocardial infarction; Serum transaminase.

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Figures

Fig. 1
Fig. 1
Incidence of recurrent MI during long-term follow-up. The incidence of recurrent MI was 2.7% at 1 year, 3.8% at 2 years, and 5.8% at 3 years
Fig. 2
Fig. 2
Association between baseline lipid values and incidence of nonfatal recurrent MI. non-HDL, non-high-density lipoprotein; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglyceride; CI, confidence interval; OR, odds radio
See this image and copyright information in PMC

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