Myocardial infarction in young adults with low-density lipoprotein cholesterol levels < or = 100 mg/dL: clinical profile and 1-year outcomes. Chest 2001 Dec;120(6):1953-8
Date
12/18/2001Pubmed ID
11742927DOI
10.1378/chest.120.6.1953Scopus ID
2-s2.0-0035680914 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
STUDY OBJECTIVES: To define the clinical profile of young adults with optimal low-density lipoprotein (LDL) cholesterol levels who present with acute myocardial infarctions (MIs); to compare and contrast differences in the clinical profiles of young adults admitted to the hospital with MIs who have LDL cholesterol levels < or = 100 mg/dL and those with LDL cholesterol values > or = 160 mg/dL; and to evaluate the clinical outcomes for the two groups at 1 year.
DESIGN: A retrospective chart review was conducted on all young men (55 years) and women (65 years) admitted to the hospital for MIs within a 2-year period (n = 232). A history of cardiovascular risk factors and 1-year outcomes were obtained.
SETTING: Rural community medical center serving a tri-state area in the midwestern United States.
PATIENTS: Patients were included in this analysis if (1) a lipid profile was drawn within 24 h of hospital admission and (2) the patient was not receiving a statin medication on hospital admission.
MEASUREMENTS AND RESULTS: Of the 183 patients who met the inclusion criteria, as many as 68% (124 patients) had LDL cholesterol levels of < or = 130 mg/dL, 29% (53 patients) had LDL cholesterol level of < or = 100 mg/dL, and only 14% (26 patients) had LDL cholesterol levels of > or = 160 mg/dL. Patients were categorized into group 1 if their LDL cholesterol level was < or = 100 mg/dL and were categorized into group 2 if their LDL cholesterol level was > or = 160 mg/dL. In group 2, 92% of patients were placed on a statin medication. By 1 year, the mean LDL cholesterol level had decreased from 188 to 106 mg/dL. The rate of coronary artery bypass graft and percutaneous coronary intervention procedures was similar between groups. Hospital readmission rates (43.4% vs 50%, respectively) and 1-year mortality rates (9% vs 8%, respectively) were not different between groups group 1 and 2.
CONCLUSIONS: Young adults experiencing acute MIs typically have acceptable cholesterol levels (ie, < or = 130 mg/dL) or optimal values (ie, < or = 100 mg/dL). In those patients with abnormal cholesterol levels, a combined strategy of aggressive intervention and adherence to secondary prevention protocols including lipid control is successful in improving outcomes.
Author List
Akosah KO, Cerniglia RM, Havlik P, Schaper AMESH terms used to index this publication - Major topics in bold
AdultAge Factors
Aged
Cholesterol, LDL
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Hypolipidemic Agents
Male
Middle Aged
Myocardial Infarction
Retrospective Studies
Risk Factors
Wisconsin