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KMID : 0882420090760060692
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Korean Journal of Medicine
2009 Volume.76 No. 6 p.692 ~ p.700
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Relationship between the low-density lipoprotein cholesterol level and clinical outcome after percutaneous coronary intervention in patients with acute myocardial infarction
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Cho Kyung-Hoon
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
Park Hyung-Wook
Hong Young-Joon
Kim Ju-Han
Jeong Myung-Ho
Yoon Nam-Sik
Yoon Hyun-Ju
Kim Soo-Hyun
Ahn Young-Keun
Kang Won-Yu
Park Keun-Ho
Lee Min-Goo
Ko Jum-Suk
Lee Shin-Eun
Sim Doo-Sun
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Abstract
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Background/Aims: This study examined the relationship between the low-density lipoprotein cholesterol (LDL-C) level and clinical outcome after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).
Methods: Between January 2006 and December 2007, 867 patients (age, 62.6±12.5 years; males, 71%) undergoing a 1-year follow-up after PCI for AMI were divided into five groups according to the LDL-C level: <70, 70-100, 100-130, 130-160, and ≥160mg/dL.
Results: Smoking (63%), hypertension (46%), and diabetes mellitus (28%) were common risk factors. The history of ischemic heart disease decreased as the LDL-C level increased (p=0.036). Patients with lower LDL-C levels had lower creatinine clearance and higher high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. The rate of in-hospital complications after PCI declined with increases in the LDL-C level, except in patients with LDL-C >160 mg/dL (linear p=0.010). There was no correlation between the LDL-C level and the 30-day or 1-year clinical outcome after PCI. After multivariate adjustment, independent predictors of the 1-year mortality after PCI were left ventricular ejection fraction, hsCRP, age, and creatinine clearance.
Conclusions: Higher LDL-C levels were related to fewer in-hospital complications, but there was no correlation between the LDL-C level and long-term clinical outcome after PCI in Korean patients with AMI.
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KEYWORD
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Myocardial infarction, Low-density lipoprotein cholesterol, Percutaneous coronary intervention
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