Impact of Achieving LDL-C Level Target and Major Adverse Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention
Kitpasut Kewcharoenvong, MD1, Naruepat Sangpornsuk, MD1, Teetouch Ananwattanasuk, MD1
Affiliation : 1Cardiology Division, Department of Internal Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Background: Serum low-density lipoprotein cholesterol (LDL-C) levels are associated with cardiovascular diseases. Elevated LDL-C levels increase the risk of cardiovascular diseases and are associated with high mortality rates. Patients with established cardiovascular diseases, particularly those undergoing percutaneous coronary intervention (PCI), are at high risk.
Objective: The present study aimed to assess the impact of achieving the target LDL-C level (LDL-C <70 mg/dL) on the incidence of major adverse cardiovascular events (MACE).
Materials and Methods: This retrospective cohort study was conducted using medical records of patients who underwent PCI at Vajira Hospital, Bangkok, Thailand. Data were collected between January 1, 2016, and December 31, 2020. Following PCI, patients were classified into two groups: those who achieved the LDL-C target (serum LDL-C level below 70 mg/dL at 3 months after PCI) and those who did not (serum LDL-C level equal to or more than 70 mg/dL at 3 months after PCI). Follow-up was performed for 1 year or until the first occurrence of composite cardiovascular outcomes (nonfatal myocardial infarction, nonfatal stroke, congestive heart failure, and cardiovascular death).
Results: Among the 205 patients who underwent PCI within the specified period, 63% were male, with a mean age of 64 years and a baseline LDL-C level of 114.92±46.46 mg/dL. Only 39.5% of patients achieved the target LDL-C level. After 1-year follow-up, MACE occurred in 18 patients who did not achieve the target LDL-C level (14.5%) and in one patient who achieved the target LDL-C level (1.2%). The multivariable Cox proportional hazard model showed that achieving the target LDL-C level significantly lowered the MACE rate (HR=0.08, 95% CI 0.011 to 0.599, p=0.01).
Conclusion: Within 1 year of follow-up after PCI, achieving an LDL-C level of less than 70 mg/dL 3 months after stent implantation considerably reduced the occurrence of severe cardiovascular events.
Received 24 August 2024 | Revised 29 January 2025 | Accepted 26 February 2025
Keywords : Low-density lipoprotein cholesterol (LDL-C); Major adverse cardiac event; Myocardial infarction; Percutaneous coronary intervention (PCI)
