Backgroud
The efficacy of intensive LDL-C reduction in early phase of ACS had been proven in some series of clinical studies and HDL-C level emerged as a novel prognostic factor in cardiovascular disease. Associated demographic or clinical variables for HDL-C change after use of lipid lowering agent in early phase of AMI were not studied much.
Methods
We have randomizly assigned 95 AMI patients into Vytorin versus simvastatin and Vytorin versus atovastatin from Aug.2006 to Mar. 2008, prospectively. We focused on HDL-C level change on 1 Mo. and 6 Mo., it is related demographics and clinical treatment mortality, retrospectively.
Restults
40/92(43.5%) and 30/80(37.5%) patient has increased HDL-C level after 1 Mo. and 6 Mo. in lipid lowering agent treatment. The male, higher height, severe coronary artery disease, initial low HDL-C level was related with increased 1 Mo. HDL-C level significantly. 11/41(26%) Vytorin and 19/39(48%) single statin using patients has increased HDL-C level after 6 Mo(p= 0.04).
Conclusion
After the application of high dose statin and Vytorin in AMI, LDL-C reduction was intensified and improved. But, HDL-C change was less considered and neglected compared to LDL-C change. Recently, HDL-C emerged important prognostic variable to predict secondary event in CVD. Some drug or clinical variables associated with HDL-C. Large scaled clinical study should be performed to enlighten this causal association and clinical impact.
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