The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study
Abstract Background Low-density lipoprotein cholesterol (LDL-C) is a well-recognized risk factor for cardiovascular diseases. However, several clinical studies demonstrated an inverse association between LDL-C and mortality risk in patients with acute myocardial infarction (AMI), known as the lipid...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-12-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-024-03823-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850086005430812672 |
|---|---|
| author | Guyu Zeng Ce Zhang Ying Song Zheng Zhang Jingjing Xu Zhenyu Liu Xiaofang Tang Xiaozeng Wang Yan Chen Yongzhen Zhang Pei Zhu Xiaogang Guo Lin Jiang Zhifang Wang Ru Liu Qingsheng Wang Yi Yao Yingqing Feng Yaling Han Jinqing Yuan |
| author_facet | Guyu Zeng Ce Zhang Ying Song Zheng Zhang Jingjing Xu Zhenyu Liu Xiaofang Tang Xiaozeng Wang Yan Chen Yongzhen Zhang Pei Zhu Xiaogang Guo Lin Jiang Zhifang Wang Ru Liu Qingsheng Wang Yi Yao Yingqing Feng Yaling Han Jinqing Yuan |
| author_sort | Guyu Zeng |
| collection | DOAJ |
| description | Abstract Background Low-density lipoprotein cholesterol (LDL-C) is a well-recognized risk factor for cardiovascular diseases. However, several clinical studies demonstrated an inverse association between LDL-C and mortality risk in patients with acute myocardial infarction (AMI), known as the lipid paradox. This study aims to investigate the potential impact of inflammation on the association between LDL-C levels and mortality risks. Methods A total of 5244 patients with AMI from a large nationwide prospective cohort were included in our analysis. Patients were stratified according to LDL-C quartiles. The primary outcome was all-cause mortality, and the secondary endpoint was cardiac mortality. High-sensitive C-reactive protein (hsCRP) > 3 mg/L was defined as high inflammatory risk. Results During a median follow-up of 2.07 years, 297 mortality events (5.5%) and 227 cardiac mortality events (4.2%) occurred. Patients in the lowest LDL-C quartile had the highest incidence of all-cause mortality (7.3%) and cardiac mortality (5.8%). A U-shaped association between LDL-C levels and mortality risk was observed after multivariable adjustment, which persisted only in patients with high hsCRP levels. In contrast, a linear association between LDL-C and mortality risk was shown in patients with low hsCRP levels. Conclusions AMI patients with lower LDL-C levels had a higher risk of mortality. However, this association was only observed in those with high inflammatory risk. In contrast, the relationship between LDL-C and mortality risk was linear in patients with low inflammatory risk. This suggests the importance of considering inflammation when managing LDL-C levels in AMI patients. |
| format | Article |
| id | doaj-art-494b4f55bded4ed18cc7e0718cfbff42 |
| institution | DOAJ |
| issn | 1741-7015 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-494b4f55bded4ed18cc7e0718cfbff422025-08-20T02:43:36ZengBMCBMC Medicine1741-70152024-12-0122111110.1186/s12916-024-03823-zThe potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter studyGuyu Zeng0Ce Zhang1Ying Song2Zheng Zhang3Jingjing Xu4Zhenyu Liu5Xiaofang Tang6Xiaozeng Wang7Yan Chen8Yongzhen Zhang9Pei Zhu10Xiaogang Guo11Lin Jiang12Zhifang Wang13Ru Liu14Qingsheng Wang15Yi Yao16Yingqing Feng17Yaling Han18Jinqing Yuan19National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, The First Hospital of Lanzhou UniversityNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, General Hospital of Northern Theater CommandNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, Peking University Third HospitalNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, The First Affiliated Hospital, Zhejiang University School of MedicineNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, Xinxiang Central HospitalNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, The First Hospital of QinHuangDaoNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, Guangdong Provincial People’s HospitalDepartment of Cardiology, General Hospital of Northern Theater CommandNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Low-density lipoprotein cholesterol (LDL-C) is a well-recognized risk factor for cardiovascular diseases. However, several clinical studies demonstrated an inverse association between LDL-C and mortality risk in patients with acute myocardial infarction (AMI), known as the lipid paradox. This study aims to investigate the potential impact of inflammation on the association between LDL-C levels and mortality risks. Methods A total of 5244 patients with AMI from a large nationwide prospective cohort were included in our analysis. Patients were stratified according to LDL-C quartiles. The primary outcome was all-cause mortality, and the secondary endpoint was cardiac mortality. High-sensitive C-reactive protein (hsCRP) > 3 mg/L was defined as high inflammatory risk. Results During a median follow-up of 2.07 years, 297 mortality events (5.5%) and 227 cardiac mortality events (4.2%) occurred. Patients in the lowest LDL-C quartile had the highest incidence of all-cause mortality (7.3%) and cardiac mortality (5.8%). A U-shaped association between LDL-C levels and mortality risk was observed after multivariable adjustment, which persisted only in patients with high hsCRP levels. In contrast, a linear association between LDL-C and mortality risk was shown in patients with low hsCRP levels. Conclusions AMI patients with lower LDL-C levels had a higher risk of mortality. However, this association was only observed in those with high inflammatory risk. In contrast, the relationship between LDL-C and mortality risk was linear in patients with low inflammatory risk. This suggests the importance of considering inflammation when managing LDL-C levels in AMI patients.https://doi.org/10.1186/s12916-024-03823-zLipid paradoxInflammationMyocardial infarctionLow-density lipoprotein cholesterol |
| spellingShingle | Guyu Zeng Ce Zhang Ying Song Zheng Zhang Jingjing Xu Zhenyu Liu Xiaofang Tang Xiaozeng Wang Yan Chen Yongzhen Zhang Pei Zhu Xiaogang Guo Lin Jiang Zhifang Wang Ru Liu Qingsheng Wang Yi Yao Yingqing Feng Yaling Han Jinqing Yuan The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study BMC Medicine Lipid paradox Inflammation Myocardial infarction Low-density lipoprotein cholesterol |
| title | The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study |
| title_full | The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study |
| title_fullStr | The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study |
| title_full_unstemmed | The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study |
| title_short | The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study |
| title_sort | potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction a multicenter study |
| topic | Lipid paradox Inflammation Myocardial infarction Low-density lipoprotein cholesterol |
| url | https://doi.org/10.1186/s12916-024-03823-z |
| work_keys_str_mv | AT guyuzeng thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT cezhang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yingsong thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT zhengzhang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT jingjingxu thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT zhenyuliu thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT xiaofangtang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT xiaozengwang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yanchen thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yongzhenzhang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT peizhu thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT xiaogangguo thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT linjiang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT zhifangwang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT ruliu thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT qingshengwang thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yiyao thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yingqingfeng thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yalinghan thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT jinqingyuan thepotentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT guyuzeng potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT cezhang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yingsong potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT zhengzhang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT jingjingxu potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT zhenyuliu potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT xiaofangtang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT xiaozengwang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yanchen potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yongzhenzhang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT peizhu potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT xiaogangguo potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT linjiang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT zhifangwang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT ruliu potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT qingshengwang potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yiyao potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yingqingfeng potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT yalinghan potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy AT jinqingyuan potentialimpactofinflammationonthelipidparadoxinpatientswithacutemyocardialinfarctionamulticenterstudy |