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Journal of Clinical Lipidology
Year: 2014  |  Volume: 8  |  Issue: 4  |  Page No.: 423 - 432

Association of preprocedural low-density lipoprotein cholesterol levels with myocardial injury after elective percutaneous coronary intervention

Xiao-Lin Li, Jian-Jun Li, Yuan-Lin Guo, Cheng-Gang Zhu, Rui-Xia Xu, Sha Li, Ping Qing, Na-Qiong Wu, Li-Xin Jiang, Bo Xu and Run-Lin Gao    

Abstract:

Background

Lower levels of low-density lipoprotein cholesterol (LDL-C) are associated with less cardiovascular risk in patients with coronary artery disease.

Objectives

To assess whether lower preprocedural LDL-C levels are associated with less risk of periprocedural myocardial injury in patients undergoing elective percutaneous coronary intervention (PCI).

Methods

We enrolled 2529 consecutive patients with normal preprocedural cardiac troponin I (cTnI) who successfully underwent elective PCI. The association between preprocedural LDL-C levels and peak cTnI levels within 24 hours after PCI was evaluated.

Results

Preprocedural LDL-C levels were correlated to postprocedural cTnI levels (r = 0.059, P = .003). In the multivariable model, preprocedural LDL-C levels between 70 and 99 mg/dL were associated with less risk of postprocedural cTnI elevation above 1 x upper limit of normal (ULN) (odds ratio [OR]: 0.804; 95% confidence interval [CI]: 0.663-0.975; P = .027) up to 15 x ULN (OR: 0.709; 95% CI: 0.530-0.949; P = .021) compared with preprocedural LDL-C levels ≥100 mg/dL. Moreover, preprocedural LDL-C levels <70 mg/dL were more strongly associated with less risk of postprocedural cTnI elevation above 1 x ULN (OR: 0.736; 95% CI: 0.584-0.927; P = .009) up to 15 x ULN (OR: 0.655; 95% CI: 0.452-0.950; P = .026).

Conclusions

Lower preprocedural LDL-C levels were associated with less risk of periprocedural myocardial injury in patients undergoing elective PCI.

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