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Relationship between Pre-Procedural Serum Lipid Profile and Post-Procedural Myocardial Injury in Patients Undergoing
Mohsen Maadani1, Seifollah Abdi1, Sepideh Parchami-Ghazaee1
1Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Insights
Lipid profile disturbances, except for very low-density lipoprotein cholesterol (VLDL), were not significant predictors of myocardial injury after percutaneous coronary intervention (PCI). Left ventricular ejection fraction and diabetes are key predictors of post-PCI myocardial injury.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Perioperative myocardial injury is a frequent complication of percutaneous coronary intervention (PCI), linked to increased cardiovascular morbidity and mortality.
- Lipid profile abnormalities are established risk factors for atherosclerotic cardiovascular diseases.
Purpose of the Study:
- To investigate the association between lipid profile levels and post-procedural myocardial injury in patients undergoing elective PCI.
Main Methods:
- A case-control study involving 138 patients undergoing PCI.
- Lipid parameters (TC, LDL-C, HDL-C, TG, VLDL) were measured pre-procedurally.
- Cardiac biomarker (CPK-MB) levels were assessed post-procedurally.
Main Results:
- While mean levels of TC, LDL-C, and TG were higher in patients with myocardial injury, the differences were not statistically significant.
- Only very low-density lipoprotein cholesterol (VLDL) showed a notable association with myocardial injury, though changes were within normal ranges.
- Lipid abnormalities, excluding VLDL, were insignificantly more frequent in the injured group.
Conclusions:
- Non-HDL-C levels were higher in patients with myocardial injury, despite being within normal ranges.
- Multivariate analysis identified left ventricular ejection fraction and diabetes as significant predictors of post-procedural CPK-MB elevation.
Background:
Along with technological progress in coronary intervention, periprocedural complications and adverse outcomes have markedly improved, yet perioperative myocardial injury is a frequent complication during percutaneous coronary intervention (PCI) and is strongly associated with post-procedural cardiovascular morbidity and mortality. Epidemiological researchers have defined lipid and lipoproteins abnormality as a risk factor for atherosclerotic cardiovascular diseases. Although several studies focus on identification the correlation between the changes of lipid profile levels and ischemic markers, there is a little information about the role of lipid profile disturbance as a predictor of periprocedural myocardial injuries.
Objectives:
This study aimed to observe the relationship between lipid profile levels and the post-procedural myocardial injury in patients undergoing elective PCI.
Patients And Methods:
This case-control study was conducted on 138 consecutive patients with a diagnosis of coronary artery disease who underwent PCI. Of a total 138, 35 patients had cardiac biomarker elevation, more than 3 × ULN, post-procedurally. The control group (n = 103), without cardiac enzyme rising after PCI were randomly chosen three times the number of patients with increased cardiac enzymes more than three times the ULN. Samples for serum lipid parameters [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and very low-density lipoprotein cholesterol (VLDL)] were collected after 12-14 fasting hours immediately pre-procedurally. The samples for CPK-MB were collected at 8, 16, and 24 hours post procedurally.
Results:
Although the mean level of TC, LDL-C and TG was higher in patients with CPK-MB more than 3×ULN post procedurally, differences were insignificant. Among different lipid parameters, only the mean level of VLDL showed a considerable association with myocardial injury. Although, this subject had a near significant (P = 0.05) enhancement in group I, the changes were in normal ranges. Lipid abnormality (except for the VLDL values) was insignificantly more frequent in group I.
Conclusions:
Although the mean level of non-HDL-C was in normal ranges, it showed a higher value in patients with a diagnosis of myocardial injury post procedurally. However, according to multivariate analysis, left ventricular ejection fraction and diabetes remained as predictors of post-procedural CPK-MB elevation.
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