Related Experiment Video
Updated: Mar 29, 2026
Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Visit-to-visit variability in LDL- and HDL-cholesterol is associated with adverse events after ST-segment elevation
Elaine Boey1, Gibson Ming Wei Gay2, Kian-Keong Poh3
1Department of Cardiology, National University Heart Centre Singapore, Singapore.
Insights
High variability in LDL-C and HDL-C levels after a heart attack (STEMI) is linked to increased risk of major adverse cardiac events. This finding highlights the importance of stable cholesterol levels for long-term patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Clinical Lipidology
- Interventional Cardiology
Background:
- ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Cholesterol variability, specifically in low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), is an emerging area of research.
- Understanding the long-term impact of cholesterol variability post-STEMI is crucial for patient management.
Purpose of the Study:
- To investigate the association between visit-to-visit variability of LDL-C and HDL-C and 5-year clinical outcomes.
- To determine if cholesterol variability is an independent predictor of major adverse cardiac events (MACE) in STEMI survivors.
Main Methods:
- Analysis of 130 STEMI patients surviving to discharge.
- Evaluation of visit-to-visit LDL-C and HDL-C variability using corrected variation independent of mean (cVIM), coefficient of variation, and standard deviation, starting 2 months post-discharge.
- Tracking of major adverse cardiac events (MACE), including death, myocardial infarction, stroke, unplanned revascularization, and heart failure admission, over a 5-year follow-up period.
Main Results:
- A significant association was found between higher visit-to-visit LDL-C variability and increased MACE incidence (p=0.049 for cVIM).
- Increased LDL-C and HDL-C variability independently predicted a higher risk of MACE, with each 0.01 cVIM increase raising MACE risk by 3.4% for LDL-C and 6.8% for HDL-C.
- Higher mean follow-up LDL-C and a higher prevalence of diabetes mellitus were also associated with MACE.
Conclusions:
- This study provides the first evidence of an independent association between visit-to-visit LDL-C and HDL-C variability and long-term MACE in STEMI patients.
- Cholesterol variability may serve as a novel risk factor for adverse outcomes following STEMI.
- Further research is warranted to explore therapeutic strategies targeting cholesterol level stability in STEMI survivors.
Introduction:
We evaluated the relationship between visit-to-visit low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) variability and 5-year clinical outcomes in patients who presented with ST-segment elevation myocardial infarction (STEMI).
Methods:
130 patients presenting with STEMI and surviving to discharge were analyzed. Visit-to-visit LDL-C and HDL-C variability was evaluated from 2 months after discharge on the basis of corrected variation independent of mean (cVIM, primary measure), coefficient of variation and standard deviation. Major adverse cardiac event (MACE) included death, myocardial infarction, stroke, unplanned revascularization, and heart failure admission.
Results:
After an average of 62.4 ± 30.5 months follow-up, 41 patients (31.5%) had experienced MACE. Compared with the non-MACE group, the MACE group had a higher visit-to-visit LDL-C variability (cVIM: 0.23 ± 0.11 vs. 0.19 ± 0.08; p = 0.049; coefficient of variation: 0.24 ± 0.12 vs. 0.19 ± 0.00; p = 0.019; standard deviation: 24.1 ± 14.5 vs. 17.6 ± 10.0; p = 0.006), mean follow-up LDL-C (p = 0.033) and a higher prevalence of diabetes mellitus (p = 0.012). After adjusting for mean follow-up cholesterol levels and diabetes mellitus, each 0.01 cVIM increase in LDL-C and HDL-C variability increased the risk of MACE by 3.4% (HR: 1.034; 95% CI: 1.004 to 1.065; p = 0.025) and 6.8% (HR: 1.068; 95% CI: 1.003 to 1.137; p = 0.04), respectively. Results derived from coefficient of variation and standard deviation as measures of cholesterol variability were similar.
Conclusion:
This is the first report to show an independent association between visit-to-visit LDL-C and HDL-C variability and long-term MACE in patients presenting with STEMI.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
08:45LDL Cholesterol Uptake Assay Using Live Cell Imaging Analysis with Cell Health Monitoring
Published on: November 17, 2018
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Coronary Artery Disease III: Clinical Manifestations
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations