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

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

来源：Journal of Clinical Lipidology, 2014, 8(4): 423-432.

DOI：10.1016/j.jacl.2014.04.002

• Low-density lipoprotein cholesterol
• Percutaneous coronary intervention
• Cardiac troponin I
• Myocardial injury

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.

• 出版日期2014-8
• 单位中国医学科学院阜外医院; 中国医学科学院北京协和医院