Association of HDL-C levels with all-cause mortality in ACS patients after PCI: a multicenter prospective cohort...

Area of Science:

• Cardiology
• Clinical Research
• Public Health

Background:

• Prognostic significance of high-density lipoprotein cholesterol (HDL-C) in acute coronary syndrome (ACS) patients post-percutaneous coronary intervention (PCI) is not fully understood.
• Understanding HDL-C's role is crucial for optimizing patient outcomes after ACS and PCI.

Purpose of the Study:

• To investigate the association between HDL-C levels and all-cause mortality in a large cohort of ACS patients undergoing PCI.
• To identify optimal HDL-C ranges for improved prognosis in this patient population.

Main Methods:

• Multicenter prospective cohort study including 17,180 ACS patients who underwent PCI.
• HDL-C levels categorized into four groups: <30, 30-60, 60-90 (reference), and ≥90 mg/dL.
• Cox proportional hazards models used for multivariable-adjusted survival analysis over a median follow-up of 49 months.

Main Results:

• A U-shaped association was observed between HDL-C levels and all-cause mortality risk.
• Compared to the reference group (60-90 mg/dL), patients with HDL-C <30 mg/dL had a 3.52-fold increased risk (HR: 3.52, 95% CI: 2.66-4.64).
• Patients with HDL-C ≥90 mg/dL also showed a significantly increased risk (HR: 2.71, 95% CI: 2.10-3.50).

Conclusions:

• Both extremely low (<30 mg/dL) and high (≥90 mg/dL) HDL-C levels are independently associated with increased all-cause mortality in ACS patients undergoing PCI.
• Maintaining HDL-C levels within the 60-90 mg/dL range may be beneficial for long-term survival in this cohort.