Association between discordance of LDL-C and non-HDL-C and clinical outcomes in patients with stent implantation: from the FU-Registry

• Published in: Heart and vessels Vol. 33; no. 2; pp. 102 - 112
• Main Authors: Shiiba, Michiyo, Zhang, Bo, Miura, Shin-ichiro, Ike, Amane, Nose, Daisuke, Kuwano, Takashi, Imaizumi, Satoshi, Sugihara, Makoto, Iwata, Atushi, Nishikawa, Hiroaki, Kawamura, Akira, Shirai, Kazuyuki, Yasunaga, Shin’ichiro, Saku, Keijiro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2018; Springer Nature B.V
• Subjects: Angina; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cholesterol; Clinical outcomes; Dialysis; Discordance; Hemodialysis; High density lipoprotein; Implantation; Implants; Low density lipoprotein; Medicine; Medicine & Public Health; Original Article; Patients; Regression analysis; Risk analysis; Risk factors; Risk management; Stents; Surgical implants; Vascular Surgery; Major adverse cardiovascular events; Non-high-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; Coronary stent implantation
• DOI: 10.1007/s00380-017-1036-x
• ISSN: 0910-8327

It is not yet clear whether the discordance of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) predicts the follow-up clinical outcome (major adverse cardiovascular events: MACEs) in patients with coronary stent implantation. Among 2015 patients with coronary stent implantation (Fukuoka University [FU]-Registry), excluding those with acute coronary syndrome or hemodialysis, we selected 801 patients who had undergone successful stent implantation with a follow-up until 18 months, and classified them into 3 groups according to baseline LDL-C and non-HDL-C levels [percentile(P)non-HDL-C more than (P)LDL-C, (P)non-HDL-C equal to (P)LDL-C, and (P)non-HDL-C less than (P) LDL-C]. We found that the discordance of (P)LDL-C and (P)non-HDL-C was not a significant predictor of MACEs. Higher LDL-C level was consistently and independently associated with higher incidences of MACEs after controlling for conventional risk factors and the type of stent used by multivariate Cox regression analyses. In conclusion, LDL-C levels are more important than non-HDL-C levels and the discordance of LDL-C and non-HDL-C levels as predictors of MACEs in patients with stable angina after stent implantation.