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Target Low-Density Lipoprotein-Cholesterol and Secondary Prevention for Patients with Acute Myocardial Infarction: A Korean Nationwide Cohort Studyopen access

Authors
Kim, J.H.Cha, J.-J.Lim, S.An, J.Kim, M.-N.Hong, S.J.Joo, H.J.Park, J.H.Yu, C.W.Lim, D.-S.Byeon, K.Kim, Sang WookShin, E.-S.Cha, K.S.Chae, J.K.Ahn, Y.Jeong, M.H.Ahn, T.H.
Issue Date
May-2022
Publisher
MDPI
Keywords
low-density lipoprotein cholesterol; myocardial infarction; secondary prevention; statin
Citation
Journal of Clinical Medicine, v.11, no.9
Journal Title
Journal of Clinical Medicine
Volume
11
Number
9
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/61384
DOI
10.3390/jcm11092650
ISSN
2077-0383
2077-0383
Abstract
Although lowering low-density lipoprotein cholesterol (LDL-C) levels following acute myocardial infarction (MI) is the cornerstone of secondary prevention, the attainment of recommended LDL-C goals remains suboptimal in real-world practice. We sought to investigate recurrent adverse events in post-MI patients. From the Korea Acute Myocardial Infarction-National Institutes of Health registry, a total of 5049 patients with both measurements of plasma LDL-C levels at index admission and at the one-year follow-up visit were identified. Patients who achieved an LDL-C reduction ≥ 50% from the index MI and an LDL-C level ≤ 70 mg/dL at follow-up were classified as target LDL-C achievers. The primary endpoint was a two-year major adverse cardiac and cere-brovascular event (MACCE), including cardiovascular mortality, recurrent MI, and ischemic stroke. Among the 5049 patients, 1114 (22.1%) patients achieved the target LDL-C level. During a median follow-up of 2.1 years, target LDL-C achievers showed a significantly lower incidence (2.2% vs. 3.5%, log-rank p = 0.022) and a reduced adjusted hazard of MACCE (0.63; p = 0.041). In patients with acute MI, achieving a target LDL-C level was associated with a lower incidence and a reduced hazard of recurrent clinical events. These results highlight the need to improve current practices for managing LDL-C levels in real-world settings. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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의과대학 (의학부(임상-광명))
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