Related Experiment Videos
Reduced high density lipoproteins as a risk factor after acute myocardial infarction
Insights
In men recovering from myocardial infarction, low high-density lipoprotein (HDL) cholesterol is a poor prognostic sign. This finding holds true even without other risk factors like diabetes or hypertension.
Area of Science:
- Cardiology
- Metabolic Syndrome
Background:
- Survivors of acute myocardial infarction (MI) often exhibit low apolipoprotein A-I and deficient fibrinolytic activity.
- Previous research identified these as key characteristics in normocholesterolemic, non-diabetic males post-MI.
Purpose of the Study:
- To investigate morbidity and mortality risk factors over a five-year period in middle-aged males post-MI.
- To identify prognostic indicators in patients with and without hypertension.
Main Methods:
- A five-year follow-up study of middle-aged males who had previously survived an acute myocardial infarction.
- Analysis of mortality rates, reinfarction, and biochemical markers including high-density lipoprotein (HDL) cholesterol, apolipoprotein A-I, and urinary cortisol levels.
- Stratification of patients based on hypertensive status.
Main Results:
- Mortality was significantly higher in the hypertensive group (40%) compared to the normotensive group (16%).
- In normotensive patients, mortality was linked to reinfarction.
- Patients with a poor prognosis (both hypertensive and normotensive) exhibited lower plasma HDL cholesterol and apolipoprotein A-I levels.
- Unexpectedly, in the hypertensive group, low urinary cortisol concentration correlated with death.
Conclusions:
- Low high-density lipoprotein (HDL) cholesterol levels may indicate a poor prognosis in males post-myocardial infarction, particularly in the absence of other major risk factors.
- Urinary cortisol levels warrant further investigation as a potential mortality predictor in hypertensive post-MI patients.
Abstract:
In a group of normocholesterolemic, non-diabetic middle-aged males surviving an acute myocardial infarction for 4 +/- 2 years (mean +/- SD), we have previously described a low apolipoprotein A-I and a deficient fibrinolytic activity as two major characteristics. In the present study we have followed morbidity and mortality risk factors for five years in these males. Mortality was 40% in a hypertensive group and 16% in a normotensive group. In the normotensive group mortality was related to reinfarction. Furthermore, patients with a poor prognosis in the normotensive group had lower high density lipoprotein (HDL) cholesterol and lower apolipoprotein A-I concentration in plasma than patients with a good prognosis. Unexpectedly, in the hypertensive group death was related to a low (p less than 0.05) cortisol concentration in urine. It is concluded that a low HDL level may be a bad prognostic sign in males who have sustained an acute myocardial infarction and show no evidence of other risk factors, such as diabetes, hypercholesterolemia or hypertension.