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Prognostic value of remnant cholesterol levels after acute phase of myocardial infarction
Session:
Posters (Sessão 3 - Écran 2) - Enfarte Agudo do Miocárdio 2
Speaker:
MIGUEL VAZ ALMEIDA SOBRAL DOMINGUES
Congress:
CPC 2023
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Miguel Sobral Domingues; João Presume; Daniel A. Gomes; Rita A. Carvalho; Joana C. Pereira; Jorge Ferreira; Catarina Brízido; Christopher Strong; António Tralhão; Marisa Trabulo; Miguel Mendes
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>INTRODUCTION: </strong>Remnant cholesterol (RM-C) is associated with development of atherosclerotic cardiovascular disease. However, its prognostic impact after acute myocardial infarction (AMI) is not well established.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>AIM:</strong> To assess the prognostic value of RM-C levels and other lipid parameters after acute phase of myocardial infarction (MI).</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>METHODS:</strong> Single-center retrospective analysis of consecutive patients admitted with MI from 2016 to 2018. Lipid parameters were measured in the first 24 hours after admission. We conducted a landmark analysis of 4-point cardiovascular events (4P-MACE) composed by all-cause death, non-fatal MI, non-fatal stroke or coronary revascularization occurring after 12 weeks post-admission for MI. The association between lipid parameters and 4P-MACE was assessed using uni- and multivariable Cox regression analysis.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>RESULTS:</strong> A total of 439 patients were included, aged 64 ± 14 years, 71% male, 74% with ST-segment elevation MI. <span style="color:black">37% were under statins at admission</span>. Prevalence of hypertension was 71%, 30% had diabetes, 17% current smokers <span style="color:black">and 24% were obese. </span>Median lipid values were 171 mg/dL <span style="color:black">[</span><span style="color:black">142-200</span><span style="color:black">]</span> for total cholesterol (TC), 98 mg/dL <span style="color:black">[75-126]</span> for low-density lipoprotein cholesterol (LDL-C), 40 mg/dL <span style="color:black">[35-50]</span> for high-density lipoprotein cholesterol (HDL-C), 131 mg/dL <span style="color:black">[94-175]</span> for triglycerides (TG), <span style="color:black">127 mg/dL </span><span style="color:black">[101-154]</span> <span style="color:black">for non-C-HDL </span>and 26 mg/dL <span style="color:black">[19-35]</span> for RM-C<span style="color:black">. The incidence of 4P-MACE at 2.4±1.1 years was 20%. </span>RM-C was the only lipid parameter associated with 4P-MACE and the association remained statistically significant after adjustment for age, sex and risk factors for ASCVD (Table 1).</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>CONCLUSIONS</strong>: In this landmark analysis of a cohort with acute MI, RM-C was the only routine lipid parameter independently associated with the risk of 4P-MACE occurring after 12 weeks post-MI.</span></span></span></p>
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