演題

Association between Low-Density Lipoprotein-Cholesterol/High-Density Lipoprotein-Cholesterol Ratio and Clinical Outcomes in Patients with Acute Coronary Syndrome and Dyslipidemia: Subanalysis of the HIJ-PROPER

[演者] Masataka Ogiso:1
[共同演者] Haruki Sekiguchi:2, Erisa Watanabe:2, Hiroyuki Arashi:2, Toshiaki Isogai:1, Hiroyuki Tanaka:1, Junichi Yamaguchi:2, Hiroshi Ogawa:2, Nobuhisa Hagiwara:2
1:Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, 2:Department of Cardiology, Tokyo Women's Medical University, Tokyo

Background:Well-controlled low-density lipoprotein-cholesterol(LDL-C) levels are important for secondary prevention of coronary artery disease,particularly in the setting of acute coronary syndrome(ACS). However,the association between other conventional lipid measures and major cardiovascular adverse events(MACEs) in patients with ACS receiving aggressive lipid-lowering management for dyslipidemia is unknown. We aimed to compare the association between high-density lipoprotein-cholesterol (HDL-C),non-HDL-C,triglycerides(TG) and LDL-C/HDL-C ratio and MACEs in patients with ACS receiving lipid-lowering therapy.Methods:This is a sub-analysis of HIJ-PROPER study, which assessed the influence of aggressive LDL-C lowering treatment using statin and ezetimibe in 1734 patients diagnosed with ACS and concomitant dyslipidemia. We performed a log rank analysis of MACEs using blood lipid profiles including HDL-C,non-HDL-C,TG, and LDL-C/HDL-C ratio.Result:We studied 1721 patients(mean age 65±12 years,men 75.5%) who were followed-up for 3 years and observed that 599 presented with MACEs. The low LDL-C/HDL-C ratio group (≤2.3) showed a significantly lower event rate than the other groups (p<0.05). Other components of the lipid profile did not show a significant association with MACEs. Based on the receiver operating characteristic(ROC) curve analysis, the optimal cut-off level for the LDL-C/HDL-C ratio was determined to be 2.5(sensitivity 67.4%,specificity 38.2%). Conclusions: Our sub-analysis of data obtained from the HIJ-PROPER study revealed that the LDL-C/HDL-C ratio as compared to other parameters was more strongly associated with MACEs in patients with ACS receiving aggressive lipid-lowering therapy.

[Keywords] acute coronary syndrome / dyslipidemia
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