In a nutshell
The purpose of this study was to investigate the cholesterol levels and the management of high cholesterol in patients with acute coronary syndrome (heart attack/angina). Patients who had a STEMI (a specific type of heart attack) had worse cholesterol levels but had better cholesterol levels after 12 months of statin therapy.
Some background
Acute coronary syndrome (ACS) is a term used to describe 3 heart-related diseases: STEMI, NSTEMI and unstable angina. A STEMI is when there is a blockage in the arteries of the heart (coronary arteries) causing damage to the full thickness of the heart muscle wall. An NSTEMI is when there is a blockage to the coronary arteries causing damage to just partial thickness of the heart muscle wall. Unstable angina is when there is a partial blockage in the coronary arteries, reducing blood flow to the heart muscle and causing chest pain. Patients with unstable angina are at high risk of having a STEMI/NSTEMI in the near future. All 3 conditions are treated as an emergency.
There are different types of cholesterol such as LDL (bad cholesterol) and HDL (good cholesterol). LDL cholesterol gets deposited in the blood vessels and forms blockages. HDL cholesterol helps remove cholesterol from the body. Statins are drugs used to lower LDL cholesterol. Target LDL level is below 70 mg/dL. It is unknown how effective intensively treating high cholesterol is in patients with ACS.
Methods & findings
This study included 19,287 patients. Their blood cholesterol levels were checked on admission to hospital and after 12 months.
36.1% of the patients had ACS including 14.3% with STEMI, 10.2% with NSTEMI and 9.9% with unstable angina. Patients with ACS had significantly higher cholesterol levels than those with other stable heart conditions. On admission, the STEMI group had the highest average LDL-cholesterol levels (127mg/dL).
91.6% of the patients who had ACS were given statin therapy at discharge for cholesterol management. 37.6% received intensive statin therapy. After 12 months, 32.4% of the patients who had STEMIs had LDL level below 70 mg/dL compared to 29.9% in patients with NSTEMI and 27.8% in patients with unstable angina.
The bottom line
The authors concluded that patients with STEMI have worse LDL cholesterol levels but respond better to statin treatment.
The fine print
The patients included in the study had very high risks for heart disease. Therefore, the results may not be representative to the general population.
Published By :
Pharmacological research
Date :
Dec 06, 2018
