scholarly journals Homozygous familial hypercholesterolemia with stenosis of the left anterior descending coronary artery successfully treated with weekly low‐density lipoprotein apheresis for 16 years without percutaneous coronary intervention

2019 ◽  
Vol 7 (8) ◽  
pp. 1608-1611 ◽  
Author(s):  
Takanori Yasu ◽  
Masahiro Shimoyama ◽  
Hiroshi Wada ◽  
Tomohiro Iwakura ◽  
Shigeru Toyoda ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Familial Hypercholesterolemia ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Low Density ◽  
Homozygous Familial Hypercholesterolemia ◽  
Lipoprotein Apheresis ◽  
Percutaneous Coronary

Abstract 344: Low Density Lipoprotein Cholesterol and Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Maneesh Sud ◽  
Lu Han ◽  
Maria Koh ◽  
Husam Abdel-Qadir ◽  
Peter Austin ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiovascular Events ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Lipoprotein Cholesterol ◽  
Major Adverse Cardiovascular Events ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Percutaneous Coronary

Introduction: Lowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of major adverse cardiovascular events (MACE). Few studies have examined LDL-C control and outcomes exclusively after percutaneous coronary intervention (PCI). Furthermore, guidelines provide no formal recommendation on when to check LDL-C after PCI. It is therefore conceivable that LDL-C is not routinely measured after PCI, many patients may have elevated LDL-C levels (≥ 70mg/dL), and that elevated LDL-C levels after PCI are associated with adverse long-term outcomes. Objective: To evaluate LDL-C levels after PCI procedures, and to assess the association between LDL-C and cardiovascular events in a population-based cohort. Methods: All patients who received their first PCI between Oct 2011 and Sep 2014 in Ontario, Canada, and had a cholesterol measurement within 6 months after PCI were included. Multivariable Fine and Gray sub-distribution hazards models were used to assess the association between LDL-C measured after PCI and the incidence of MACE (myocardial infarction, coronary revascularization, stroke and cardiovascular death) through December 31, 2016. Results: There were 47,884 patients who had their first PCI during the study period, and 52% had an LDL-C measurement within 6 months post-procedure (median age 63 years, 27% female). Among them, 57% had LDL-C < 70mg/dL, 28% had LDL-C 70 to < 100mg/dL, and 15% had LDL-C ≥ 100mg/dL. After a median of 3.2 years of follow-up, 19% of patients had a qualifying MACE. After adjustment, the incidence of MACE was significantly higher in patients with higher LDL-C levels (Figure). Conclusions: Only one in two patients had LDL-C measured within 6 months after undergoing PCI and only about half had LDL-C < 70mg/dL. Higher levels of LDL-C after PCI were associated with a significantly higher incidence of MACE. Recommendations for routine LDL-C assessment and optimization may improve patient outcomes after PCI procedures.

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