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

• Published in: Journal of clinical lipidology 2014-07, Vol.8 (4), p.423-432
• Main Authors: Li, Xiao-Lin, MD, Li, Jian-Jun, MD, PhD, Guo, Yuan-Lin, MD, Zhu, Cheng-Gang, MD, Xu, Rui-Xia, PhD, Li, Sha, MD, Qing, Ping, MD, Wu, Na-Qiong, MD, Jiang, Li-Xin, MD, Xu, Bo, MBBS, Gao, Run-Lin, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Cardiac troponin I; Cardiovascular; Cholesterol, LDL - blood; Female; Humans; Low-density lipoprotein cholesterol; Male; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - surgery; Myocardial injury; Percutaneous Coronary Intervention; Postoperative Period; Preoperative Period; Prognosis; Treatment Outcome; Troponin I - blood
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2014.04.002

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 × upper limit of normal (ULN) (odds ratio [OR]: 0.804; 95% confidence interval [CI]: 0.663–0.975; P  = .027) up to 15 × 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