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Elevated low-densit...
Elevated low-density lipoprotein cholesterol : An inverse marker of morbidity and mortality in patients with myocardial infarction
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- Schubert, Jessica (författare)
- Uppsala University,Uppsala universitet,Kardiologi
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- Lindahl, Bertil, 1957- (författare)
- Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Melhus, Håkan (författare)
- Uppsala University,Uppsala universitet,Klinisk farmakogenomik och osteoporos
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- Renlund, Henrik, 1979- (författare)
- Uppsala University,Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Leosdottir, Margrét (författare)
- Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital
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- Yari, Ali (författare)
- Karolinska Institutet
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- Ueda, Peter (författare)
- Karolinska Institutet,Karolinska Institute
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- Jernberg, Tomas (författare)
- Karolinska Institutet
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- Hagström, Emil (författare)
- Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- John Wiley & Sons, 2023
- 2023
- Engelska.
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Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 0954-6820 .- 1365-2796. ; 294:5, s. 616-627
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Abstract
Ämnesord
Stäng
- BackgroundThe incidence of atherosclerotic cardiovascular disease increases with levels of low-density lipoprotein cholesterol (LDL-C). Yet, a paradox may exist where lower LDL-C levels at myocardial infarction (MI) are associated with poorer prognoses.ObjectiveTo assess the association between LDL-C levels at MI with risk factor burden and cause-specific outcomes.MethodsStatin-naive patients hospitalized for a first MI and registered in SWEDEHEART were included. Data were linked to Swedish registers. Primary outcomes were all-cause mortality and nonfatal MI. Associations between LDL-C and outcomes were assessed using adjusted proportional hazards models.ResultsAmong 63,168 patients (median age, 66 years), the median LDL-C level was 3.0 mmol/L (interquartile range 2.4–3.6). Patient age and comorbidities increased as LDL-C decreased. During a median follow-up of 4.5 years, 10,236 patients died, and 4973 had nonfatal MI. Patients with the highest LDL-C had a lower risk of mortality (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.71–0.80). The risk of hospitalization for pneumonia, hip fracture, chronic obstructive pulmonary disease, and new cancer diagnosis was lower with higher LDL-C (HR range, 0.40–0.81). Patients with the highest LDL-C had a greater risk of recurrent MI (HR 1.16; 95% CI 1.07–1.26).ConclusionsPatients with the highest LDL-C levels at MI had the lowest incidence of mortality and morbidity. This seems to reflect lower age at MI, less underlying morbidities, paired with the modifiability of LDL-C. However, supporting the causal association between LDL-C and ischemic heart disease, elevated LDL-C was simultaneously associated with an increased risk of nonfatal MI.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- atherosclerosis
- cholesterol
- myocardial infarction
- lipid lowering
- observational
- prevention
- atherosclerosis
- cholesterol
- lipid lowering
- myocardial infarction
- observational
- prevention
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Schubert, Jessic ...
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Lindahl, Bertil, ...
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Melhus, Håkan
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Renlund, Henrik, ...
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Leosdottir, Marg ...
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Yari, Ali
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visa fler...
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Ueda, Peter
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Jernberg, Tomas
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Hagström, Emil
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
- Artiklar i publikationen
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Journal of Inter ...
- Av lärosätet
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Uppsala universitet
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Lunds universitet
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Karolinska Institutet