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Lower TC:HDL, LDL tied to higher mortality rates in patients with ACS

Elaine Soliven
28 Jul 2017

Lower total cholesterol-to-high density lipoprotein cholesterol ratio (TC:HDL) and low-density lipoprotein (LDL) levels appear to be associated with elevated mortality rates in patients with acute coronary syndrome (ACS), according to a study presented at the 21st Asian Pacific Society of Cardiology Congress (APSC 2017) held in Singapore.

Using data from Hospital Sungai Buloh, Selangor, Malaysia, researchers conducted a prospective, observational study involving 1,479 patients with ACS (mean age 56 years, 70.8 percent male), 56.6 percent (n=837) of whom had LDL levels ≥2.6 mmol/L. About 46 percent had unstable angina, 29.6 percent had non-ST elevation myocardial infarction (NSTEMI), and 24.5 percent had STEMI. [APSC 2017, abstract P157]

Mean total cholesterol, HDL, LDL, and triglyceride levels were 5.65, 1.02, 3.07, and 1.86 mmol/L, respectively.

Compared with higher TC:HDL ratio (≥3.5 mmol/L), patients with lower TC:HDL (<3.5 mmol/L) had a higher 30-day mortality rate (17.5 percent vs 4.7 percent).

Patients with lower LDL levels (<2.6 mmol/L) also had a higher 30-day mortality rate (11 percent vs 4.5 percent; p<0.005) and risk of NSTEMI (34.2 percent vs 28.3 percent) than those who had higher LDL (≥2.6 mmol/L).

On the other hand, a higher risk of STEMI was observed in patients with higher LDL compared with lower LDL levels (23.7 percent vs 16.7 percent).

The results also showed that hypertension was the most common risk factor for ACS (65.9 percent), followed by diabetes mellitus (48.5 percent), ischaemic heart disease (42.7 percent), and dyslipidaemia (29.3 percent) as well as smoking (27.9 percent).

“Interestingly, lipid profile was not an independent mortality predictor in our cohort,” according to lead author Dr Affida Ahmad from the Department of Cardiology at Universiti Teknology Mara in Sungai Buloh.

Although most patients with ACS typically have higher levels of LDL, the higher mortality rate and risk of NSTEMI in the lower LDL group in this study emphasizes the significance of managing the associated risk factors of ACS concurrently, Ahmad added.
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Most Read Articles
Pearl Toh, 08 Jun 2016
Middle East Respiratory Syndrome (MERS) patients have more severe illness and a higher mortality rate than non-MERS severe acute respiratory infection (SARI) patients, according to a study presented at the recent American Thoracic Society (ATS) International Conference 2016 held in San Francisco, California, US.
Radha Chitale, 19 May 2016
Women with atrial fibrillation (AF) are more symptomatic, more functionally impaired, and have worse quality of life compared with men with AF, although women are less likely to die, according to an observational cohort study comparing sex differences in AF.
01 Jun 2016
Valsartan plus amlodipine reduces albuminuria in chronic kidney disease (CKD) patients with hypertension, a randomised clinical trial showed.
01 Dec 2015
Sublingual nitroglycerin enhances coronary diameter, assessable segment numbers, image quality, and diagnostic accuracy of coronary computed tomography angiography, as reported in a systematic review of nine studies.