Cardiology Medical News about high HDL cholesterol;risk;percutaneous coronary intervention-related MI;long-term outcome

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High high-density lipoprotein-cholesterol reduces risk and extent of percutaneous coronary intervention-related myocardial infarction and improves long-term outcome in patients undergoing elective percutaneous coronary intervention
European Heart Journal, 06/05/09

Sattler KJE et al. – Small increases in high-density lipoprotein-cholesterol (HDL-C) in pts undergoing elective percutaneous coronary intervention (PCI) convert into a substantial reduction of risk for PCI-related myocardial infarction (PMI), which has adverse effects on long-term prognosis. Pts with PMI are at a high risk for acute myocardial infarction (AMI) at any HDL-C level and therefore should receive particular monitoring by the treating physician over a long period after PCI.

Methods

Study of whether HDL-C has an effect on PCI-induced myocardial infarction and its prognosis
Elevation of cardiac troponin I (cTnI) > 3x upper normal limit after PCI is defined as PMI associated with negative prognosis
Assessment of pre-procedural HDL-C levels and post-procedural peak cTnI levels in 350 PCI pts
Analysis of data for PMI and for AMI during follow-up

Results

Lower HDL-C levels for PMI pts (n = 115) vs pts without PMI (n = 235)
Pre-procedural HDL-C levels inversely related to occurrence of PMI and to AMI during follow-up
Occurrence of PMI associated with elevated HR for AMI
Low-risk levels of pre-procedural HDL-C did not influence negative effects of PMI on outcome and reduction of AMI-free survival

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