Prognostic Value Of Non High Density Lipoprotein Cholesterol For The Occurrence Of Cardiovascular Events In Patients With Acute Coronary Syndrome

Objective1. To investigate the prognostic value of non high density lipoprotein cholesterol(non-HDL-C) for the occurrence of cardiovascular events in patients with acutecoronary syndrome(ACS).2. To explore whether the prognostic value of non high density lipoproteincholesterol (non-HDL-C) differs between males and females with acute coronarysyndrome(ACS).MethodsThis study enrolled324cases with ACS between2008and2010, and followed up18months in median. Cardiovascular events in this study included primary (all-causemortality, nonfatal myocardial infarction and nonfatal stroke)and secondary(class IVheart failure and revascularization treatment)end-point events. The association betweenbaseline non-HDL-C level with the risk of primary and secondary end-point eventsanalyzed by Cox regression and Kaplan-Meier curve analysis.The similar analysis wasapplied both in males and females.All statistical tests were two-sided and P＜0.05wasregarded as statistically significant.SPSS13.0was used for all statistical analyses. Results1. The baseline level of non-HDL-C of patients with primary end-point events washigher (3.75±1.12mmol/l)than that in patients without the events(3.07±0.69mmol/l, p<0.05).2. Cox regression analysis showed that high non-HDL-C at baseline was a keypredictor of primary end-point events (OR2.996,95%CI1.269-7.072,P=0.012),and only for all-cause mortality(OR2.983,95%CI1.189-7.482,P=0.020).3. In female ACS patients,Kaplan-Meier cumulative primary cardiac event rates forhigher non-HDL-C was higher than the lower group(P=0.018),it was not so inmales.ConclusionBaseline level of non-HDL-C had a prognostic value of primary end-point events,but only of all-cause mortality,and played as an important clinical target formonitoring ACS prognosis and guiding lipid management,what is more,theprognostic value was more meaningful in females.