Impact of low early high-density lipoprotein cholesterol on inhospital outcome and short-term prognosis in patients with acute coronary syndrome

Tarek Elkholy, E. Saeed, M. Abo Omar, Yasser El-barbary
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Abstract

Background: Acute coronary syndrome (ACS) is a cardiac emergency and constitutes a major burden globally. Association between serum lipid and ACS is established many years ago. Our study tried to have more information about the impact of high-density lipoprotein cholesterol (HDL-C) on inhospital outcome and short-term prognosis of patients with ACS. Materials and Methods: The study was a prospective comparative study. Clinical and chemical and interventional evaluation was done in hospital settings. A total number of 50 patients were included in the study and divided into two groups. Patients with low HDL-C level were in Group I and patients with normal HDL-C were in Group II. Results: Group I populations had more inhospital complications than Group II represented in acute heart failure (48% vs. 13%), cardiogenic shock (40% vs. 6%), complex coronary lesions (57% vs. 20%), and prolonged hospital stay (54% vs. 20%). A statistical significance was found regarding these variables (P < 0.05). Regarding the outcome after 1 month, it is observed that patients of Group I significantly experienced heart failure (59.38% vs. 21.43%) and worsening angina (62.5% vs. 28.57%) with a statistically significant difference. In contrast, there is no statistically significant difference regarding myocardial infarction, new cerebrovascular events, shock, and mortality. Conclusion: The study showed a strong association of HDL-C level with inhospital adverse events of ACS patients in addition to short-term adverse events. Complications of ACS were more in patients with low HDL-C level.
早期低高密度脂蛋白胆固醇对急性冠状动脉综合征患者住院结局和短期预后的影响
背景:急性冠状动脉综合征(ACS)是一种心脏急症,是全球的主要负担。血脂与ACS之间的联系是多年前建立的。我们的研究试图获得更多关于高密度脂蛋白胆固醇(HDL-C)对ACS患者住院结局和短期预后影响的信息。材料与方法:本研究为前瞻性比较研究。临床、化学和介入性评价在医院进行。共纳入50例患者,分为两组。低HDL-C组为ⅰ组,正常HDL-C组为ⅱ组。结果:I组患者在急性心力衰竭(48%比13%)、心源性休克(40%比6%)、复杂冠状动脉病变(57%比20%)和延长住院时间(54%比20%)方面的院内并发症多于II组。各变量间差异均有统计学意义(P < 0.05)。1个月后的结局,观察到I组患者明显心衰(59.38% vs. 21.43%),心绞痛加重(62.5% vs. 28.57%),差异有统计学意义。相比之下,在心肌梗死、新发脑血管事件、休克和死亡率方面没有统计学上的显著差异。结论:本研究显示,除了短期不良事件外,HDL-C水平与ACS患者住院不良事件有很强的相关性。低HDL-C患者ACS并发症较多。
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