Valor pronóstico del conocimiento del perfil lipídico en los pacientes ingresados por un primer síndrome coronario agudo

Abstract

Introduction and objectives

Low-density lipoprotein cholesterol (LDL-C) values are linearly associated with the incidence of ischemic heart disease, although many people are unaware of whether or not they have dyslipidemia.

Methods

Retrospective study of all patients admitted for a first acute coronary syndrome (ACS). We considered ignorance of the lipid profile when there was no previous diagnosis of dyslipidemia, no lipid-lowering treatment was followed, nor was there laboratory determination of LDL-C in the last 5 years.

Results

A total of 3122 patients were included, aged 67.1 (13.2) years, 73.4% men and 54% admitted for ST-segment elevation acute coronary syndrome (STEACS); 1325 (42.44%) did not know their cholesterol levels and the associated variables were not having high blood pressure or diabetes, age < 55 years, male sex, low burden of comorbidity and presentation as STEACS. A significant interaction was detected between age and knowledge of dyslipidemia (P = .02). Hospital mortality was 6.5% (201 patients) and was the same in patients who knew or did not know their cholesterol levels; However, it was higher in those who did not know their LDL-C and were < 65 years of age (3.8% vs 1.5%; P < .01). The multivariate analysis identified an independent association between ignorance of cholesterol and in-hospital mortality, but only in patients aged < 65 years (OR, 2.39; 95%CI, 1.12-5.27; P = .031).

Conclusions

Cholesterol unawareness is very prevalent in patients admitted for a first acute coronary syndrome and it is associated to higher in-hospital mortality rates for patients < 65 years old.