Background and Objectives: Role of statin in patients with acute coronary syndrome (ACS) has increased, and low-density lipoprotein cholesterol (LDL-C) reduction leads lower coronary event rates. However, the impact of on-treatment triglyceride (TG) has not been evaluated well. We studied the effect of lipid level during statin treatment on prognosis in patients with ACS and percutenous coronary intervention (PCI).
Subjects and Methods: Between January 2005 and May 2007, 325 ACS patients who underwent PCI and received statin were evaluated. We measured serum lipid level at baseline and 4 weeks. The relationship between on-treatment levels of TG and LDL-C and one year major adverse cardiac event (MACE) consist of death, myocardial infarction, repeated revascularization and ischemic stroke were assessed.
Results: 71% of patients were received rosuvastatin, mean LDL-C at 4 weeks was 72.5±23.8 mg/dL. MACE occurred in 41 cases (12.6%). Baseline total cholesterol, TG and LDL-C levels were similar between the patients with MACE and those without MACE. However, the patients with MACE showed significantly higher in 4 weeks TG level (149.6±81.4 vs. 119.3±58.9 mg/dL, p=0.026) than in those without MACE. High on-treatement TG (≥150mg/dL) was associated with increased adverse events compared with lower TG in univariate analysis (hazard ratio 3.3, 95% CI 1.8~6.0, p<0.001). High LDL-C (≥70mg/dL) and high C-reactive protein (≥2mg/L) were not associated with MACE. In multivariate analysis, high 4 weeks TG level after statin treatment was an independent predictor for MACE (HR 3.8, 95% CI 1.7~8.6, p=0.001), however, baseline TG and LDL levels were not.
Conclusion: On-treatement TG ≥150mg/dL was associated with a higher risk of MACE. This findings support that achieving low TG may be important therapeutic parameters in statin-treated patients following ACS and PCI.
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