Abstract 12201: High-Density Lipoprotein Cholesterol Levels and Cardiovascular Outcomes in Japanese Patients After Percutaneous Coronary Intervention: A Report From the CREDO-Kyoto Registry Cohort-2

Abstract

Background: Low levels of HDL-C is associated with increased coronary risks in patients without known coronary artery disease (CAD) and high risks of cardiovascular events in patients with stable CAD. But it is still controversial whether low HDL-C influences cardiovascular outcomes, especially in patients with known CAD receiving current optimized treatments. Objective: We determined whether low HDL-C is a risk factor for adverse cardiovascular events in patients with known CAD who underwent percutaneous coronary intervention (PCI). Methods: We evaluated 10,391 patients who underwent PCI from January 2005 to December 2007. In total, 3,838 (36.9%) patients had low HDL-C (HDL-C <40 mg/dL in males and <50 mg/dL in females) and 6,553 (63.1%) patients had normal HDL-C based on measurements on admission. Results: The unadjusted 5-year incidence of major adverse cardiac events (MACE: composite of cardiovascular death, myocardial infarction or stroke) was significantly higher in the low HDL-C group than in the normal HDL-C group (17.6% vs. 14.0%, P<0.0001). However, after adjusting for confounders, low HDL-C was not associated with a higher risk of MACE (adjusted hazard ratio [HR] 1.07, 95% confidence interval (CI) 0.97-1.19; P=0.19). There was no significant interaction between the effect of low HDL-C on MACE and several subgroup factors including age, sex, clinical presentation of CAD, statins use, serum low-density lipoprotein cholesterol level, and serum triglycerides level. Conclusions: Low HDL-C, as compared with normal HDL-C, was not associated with higher 5-year risk of MACE in patients who underwent PCI.