Sex difference between target levels of cholesterol-related parameters and post-PCI long-term clinical outcomes: From the FU-Registry. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Matsuoka, Yuta; Ike, Amane; Ogawa, Masahiro; Gondo, Kouki; Shirai, Kazuyuki; Sugihara, Makoto; Nose, Daisuke; Nishikawa, Hiroaki; Iwata, Atsushi; Kawamura, Akira; Mori, Ken; Zhang, Bo; Yasunaga, Shin'ichiro; Miura, Shin-ichiro; Saku, Keijiro
• Is Part Of: Journal of cardiology. Volume 71:Issue 3(2018)
• Page Start: 259
• Page End: 267
• Publication Date: 2018-03
• Subjects: Lipids -- Target levels -- Sex difference -- Percutaneous coronary intervention -- Long-term clinical outcomes; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2017.09.011
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: Single lipid parameters are too weak to predict the risk of coronary artery disease. Major adverse cardiac events (MACEs) after percutaneous coronary intervention and the target level of lipids differs between sexes. In females, high-density lipoprotein cholesterol <40 mg/dl and low-density lipoprotein cholesterol ≥100 mg/dl related to MACE. Such a combination was not related to MACEs in male patients. Abstract: Background: Since single lipid parameters are too weak to predict the risk of coronary artery disease, we examined whether the allocation of patients into four groups based on achievement of the target levels set by the Japan Atherosclerosis Guidelines at the time of percutaneous coronary intervention (PCI) would reveal different long-term (5 years) clinical outcomes in males and females. Methods: The results of a 5-year follow-up study are summarized as FU-Registry, Long-Term Clinical Outcome Results. The subjects consisted of 1158 patients who underwent elective PCI. The male and female patients were separately allocated into four groups: (1) high-density lipoprotein cholesterol (HDL-C ≥ 40 mg/dl as well as low-density lipoprotein-cholesterol (LDL-C) ≥ 100 mg/dl); (2) HDL-C ≥ 40 mg/dl as well as LDL-C < 100 mg/dl; (3) HDL-C < 40 mg/dl as well as LDL-C ≥ 100 mg/dl; (4) HDL-C < 40 mg/dl as well as LDL-C < 100 mg/dl, for a comparison of both patient as well as lesion characteristics and the endpoint of major adverse cardiac events (MACEs). Results: Regarding lesion characteristics, significant differences ( p < 0.05) were detected in the usage rate of a drug-eluting stent (DES) as well as the bend, stent reference diameter, and stent minimum lumen diameter in females by ANOVA, and in severe calcification, the bend, and usage rate of DES ( p < 0.001) in males. In females, significant differences ( p < 0.05) were observed in MACEs and target lesion revascularization-PCI. In contrast, among males, the four groups had nearly equivalent outcomes. Uni- and multivariate analyses revealed that HDL-C as well as LDL-C in females were associated with MACEs [OR 3.29 (95% CI 1.05–8.57, p = 0.04)], while no association was observed in male multivariate analysis. Conclusion: In female patients, HDL-C < 40 mg/dl and LDL-C ≥ 100 mg/dl were even more strongly related to MACEs, whereas the combination of LDL-C and HDL-C was not related to MACEs in male patients.