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 Wook; Shin, 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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