Trinidad Rafael, Gómez José, García Mateo José, Magraner Miguel, Bredy Rafael
Department of Internal Medicine, Hospital Damas, Ponce, Puerto Rico. .
Bol Asoc Med P R. 2011 Apr-Jun;103(2):31-4.
There is an identified relationship between increasing plasma cholesterol and the incidence of Acute Coronary Syndrome (ACS). The National Cholesterol Education Program Adult Treatment Panel identified low-density lipoprotein--cholesterol (LDL-C) as the first target of therapy and non high-density lipoprotein cholesterol (Non HDL-C) as the second target. However, in epidemiologic studies non-HDL is a superior predictor of cardiovascular risk compared with LDL-C. We don't know the independent association of non HDL-C and LDL-C in Hispanic population with ACS.
We evaluated patients with acute coronary syndrome admitted to Damas Hospital CCU, ICU & Telemetry Unit during a five months period and previous criteria of uncontrolled lipid levels. We compared the independent association of uncontrolled lipids levels with subsequent acute coronary syndrome.
Of 26 patients with ACS, 58% had independently association with non HDL-C elevation and 42% with LDL-C elevation. Regardless the categorization of the cardiovascular event, 6 of the 8 female patients had predominantly elevated blood levels of LDL as an independent factor. On the other hand, 15 of 18 male patients had Non-HDL elevated blood levels.
The association of ACS with independent lipid levels of LDL and non-HDL seems to be equivalent in our population. Interestingly there seems to be a female predominance in elevated LDL levels and a male predominance elevated blood levels of Non-HDL associated with cardiovascular events.
血浆胆固醇升高与急性冠状动脉综合征(ACS)的发病率之间存在已确定的关系。国家胆固醇教育计划成人治疗小组将低密度脂蛋白胆固醇(LDL-C)确定为治疗的首要目标,将非高密度脂蛋白胆固醇(Non HDL-C)确定为次要目标。然而,在流行病学研究中,与LDL-C相比,非高密度脂蛋白是心血管风险的更优预测指标。我们尚不清楚在患有ACS的西班牙裔人群中,非HDL-C和LDL-C的独立关联情况。
我们评估了在五个月期间入住达马斯医院冠心病监护病房、重症监护病房和遥测病房且有血脂水平未得到控制的先前标准的急性冠状动脉综合征患者。我们比较了血脂水平未得到控制与随后急性冠状动脉综合征之间的独立关联。
在26例ACS患者中,58%与非HDL-C升高独立相关,42%与LDL-C升高独立相关。无论心血管事件如何分类,8例女性患者中有6例主要是LDL血液水平升高作为独立因素。另一方面,18例男性患者中有15例非HDL血液水平升高。
在我们的人群中,ACS与LDL和非HDL的独立血脂水平之间的关联似乎相当。有趣的是,似乎在与心血管事件相关的LDL水平升高方面女性占主导,而在非HDL血液水平升高方面男性占主导。