Which Parameter Related to Low-Density Lipoprotein Cholesterol is Superior for Predicting the Recurrence of Myocardial Infarction in Young Patients with Previous Coronary Heart Disease? A Real-World Study
Background: Lowering low-density lipoprotein cholesterol (LDL-C) is a well-established strategy for the secondary prevention of coronary heart disease (CHD). However, the effectiveness of specific LDL-C parameters in predicting myocardial infarction (MI) recurrence in real-world s...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2025-02-01
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| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/26/2/10.31083/RCM25721 |
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| Summary: | Background: Lowering low-density lipoprotein cholesterol (LDL-C) is a well-established strategy for the secondary prevention of coronary heart disease (CHD). However, the effectiveness of specific LDL-C parameters in predicting myocardial infarction (MI) recurrence in real-world settings remains inadequately explored. This study aims to examine the relationship between MI recurrence and various LDL-C parameters in young CHD patients. Methods: This retrospective cohort study involved 1013 patients aged 18–44 at the time of initial CHD diagnosis, collected from the cardiology department clinics at Beijing Anzhen Hospital between October 2022 and October 2023. LDL-C levels were assessed at the time of CHD diagnosis and at the final follow-up. The primary outcome was MI events, analyzed using survival analysis and logistic regression models to determine associations with LDL-C parameters. Results: The study included 1013 patients (mean age: 38.5 ± 3.9 years; 94.7% men), with a median follow-up time of 1.7 years. Initially, 13.6% had LDL-C levels <1.8 mmol/L, which increased to 37.8% by the study’s end. During follow-up, 96 patients (9.5%) experienced MI. While LDL-C <1.8 mmol/L at baseline showed a slightly lower cumulative incidence of MI than LDL-C ≥1.8 mmol/L, the difference was not statistically significant (log-rank p = 0.335). Reductions in LDL-C levels of ≥50% and the patterns of change did not correlate with decreased MI risk. However, LDL-C <1.4 mmol/L at the final measurement was associated with a reduced MI risk (adjusted odds ratio [OR]: 0.57, 95% confidence interval [CI]: 0.33–0.98) compared with LDL-C ≥2.6 mmol/L. Conclusions: This study suggests that the most important parameter related to LDL-C for predicting the recurrence of MI in young patients with a history of CHD is the ideal target LDL-C level. Lowering LDL-C to <1.4 mmol/L could potentially reduce MI risk, regardless of baseline LDL-C levels. |
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| ISSN: | 1530-6550 |