Impact of increased admission lipid levels on periprocedural myocardial injury following an elective percutaneous coronary intervention

Coron Artery Dis. 2015 Jun;26(4):333-40. doi: 10.1097/MCA.0000000000000235.

Abstract

Objective: Periprocedural myocardial injury (PMI) is known to be a predictor of in-hospital cardiac events and long-term adverse outcomes following a percutaneous coronary intervention (PCI). We aimed to evaluate the correlation between preprocedural serum lipid levels and PMI in patients undergoing elective PCI.

Patients and methods: The final study group included 195 patients (60.1±0.7 years old, 68 women and 127 men). Serum high-sensitive troponin T (hscTnT) concentrations were measured immediately before PCI and 12 h after PCI. Serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglyceride (TG) levels were determined immediately before PCI. Serum hscTnT concentrations were adjusted for the clinical and procedural characteristics of the patients using the weighted least-square regression analysis.

Results: The average preprocedural hscTnT concentration was 8.1±0.2 ng/l. The average serum hscTnT concentration increased to 34.1±2.8 ng/l (P<0.001) 12 h after PCI. Postprocedural hscTnT concentrations were correlated positively to serum concentrations of TC (r=0.435; P<0.001), LDL-C (r=0.349; P<0.001), and TG (r=0.517; P<0.001). There was also a positive correlation (r=0.205; P<0.01) between postprocedural hscTnT and lesion length. Mild-moderate PMI (postprocedural hscTnT≥14 to <70 ng/l) and severe PMI (postprocedural hscTnT≥70 ng/l) were observed in 122 (48.7%) and 27 (13.9%) patients, respectively. The patients with severe PMI had higher serum TC (P<0.001), LDL-C (P<0.001), and TG (P<0.001) concentrations.

Conclusion: The present study indicates that increased preprocedural TC, LDL-C, and TG serum levels are associated with PMI and its severity following elective PCI.

MeSH terms

  • Cholesterol / blood*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Female
  • Humans
  • Hyperlipidemias / blood*
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / surgery
  • Percutaneous Coronary Intervention*
  • Preoperative Period
  • Triglycerides / blood
  • Troponin / blood

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides
  • Troponin
  • Cholesterol