Optimal low-density lipoprotein cholesterol target level in Korean acute myocardial infarction patients (<70 mg/dL vs. <55 mg/dL): Based on Korea acute myocardial infarction registry-National Institute of Health. (15th March 2022)

• Record Type: Journal Article
• Authors: Ahn, Joon Ho; Ahn, Youngkeun; Jeong, Myung Ho; Kim, Ju Han; Hong, Young Joon; Sim, Doo Sun; Kim, Min Chul; Cho, Kyung Hoon; Hyun, Dae Yong; Lee, Seung Hun; Kim, Hyo-Soo; Gwon, Hyeon Cheol; Seong, In Whan; Hur, Seung-Ho; Oh, Seok Kyu
• Is Part Of: International journal of cardiology. Volume 351(2022)
• Page Start: 15
• Page End: 22
• Publication Date: 2022-03-15
• Subjects: Target LDL cholesterol -- Myocardial infarction -- Korean -- <70 mg/dL vs. <55 mg/dL -- Prognosis; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.12.020
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Current treatment guidelines for acute myocardial infarction (AMI) recommend lowering low density lipoprotein cholesterol (LDL-C). However, previous clinical studies among East Asian AMI patients failed to prove its clinical efficacy of lipid lowering therapy based on Western target LDL-C level. Thus, the purpose of this study is directly to compare the clinical outcomes of target LDL-C &lt; 70 mg/dL and &lt; 55 mg/dL and identify optimal target LDL-C level and in Korean AMI patients. Methods and results: A total of 2198 AMI patients in Korea AMI Registry – National Institute of Health were enrolled. Patients were initially divided into LDL-C non-target group ( n = 1115) and target group ( n = 1083). Successful achievement of follow up target LDL-C was defined as &lt;70 mg/dL and ≥ 50% reduction from baseline. Target group patients were additionally divided to &lt;70 mg/dL group ( n = 698) and &lt;55 mg/dL group ( n = 385). Propensity score matching analysis was done in non-target vs. target group and &lt;70 mg/dL vs. &lt;55 mg/dL group. In the matched population, the risk of 3 years major adverse cardiac event (MACE) (13.0% vs 9.8%, HR: 0.73; 95% CI: 0.56–0.96; p = 0.025) was higher in non-target group patients. However, the risk of MACE was similar in &lt;70 mg/dL and &lt; 55 mg/dL group patients (10.0% vs 8.1%, HR: 0.75, 95% CI: 0.46–1.22; p = 0.247). Conclusion: In the present study, target LDL-C level of &lt;70 mg/dL and ≥ 50% reduction from baseline level was associated with better clinical outcomes in Korean AMI patients. However, further lowering target LDL-C level of &lt;55 mg/dL showed no additional benefits. Highlights: Optimal target low density lipoprotein cholesterol level is not fully investigated in Korean acute myocardial infarction Target low density lipoprotein cholesterol levels of &lt;70 mg/dL and a ≥50% reduction from baseline levels was associated with better clinical outcomes in Korean acute myocardial infarction patients. However, reducing target levels of &lt;55 mg/dL showed no additional clinical benefits.