Target Low-Density Lipoprotein-Cholesterol and Secondary Prevention for Patients with Acute Myocardial Infarction: A Korean Nationwide Cohort Studyopen access
- Authors
- Kim, Ju Hyeon; Cha, Jung-Joon; Lim, Subin; An, Jungseok; Kim, Mi-Na; Hong, Soon Jun; Joo, Hyung Joon; Park, Jae Hyoung; Yu, Cheol Woong; Lim, Do-Sun; Byeon, Kyeongmin; Kim, Sang-Wook; Shin, Eun-Seok; Cha, Kwang Soo; Chae, Jei Keon; Ahn, Youngkeun; Jeong, Myung Ho; Ahn, Tae Hoon
- Issue Date
- May-2022
- Publisher
- MDPI AG
- Keywords
- myocardial infarction; low-density lipoprotein cholesterol; statin; secondary prevention
- Citation
- Journal of Clinical Medicine, v.11, no.9
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Clinical Medicine
- Volume
- 11
- Number
- 9
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/60935
- 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 cerebrovascular 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.
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- Appears in
Collections - 2. Clinical Science > Department of Pathology > 1. Journal Articles
- 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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