所属 医学部 医学科（東京女子医科大学病院） 職種 特任教授
|発表タイトル||Association Between the Low-Density Lipopotein Cholesterol/High-Density Lipoprotein-Cholesterol Ratio and
Clinical Outcomes in Patients With Acute Coronary Syndrome and Dyslipidemia: A Subanalysis of the HIJ-PROPER Study
|会議名||ACC.18 (67th Annual Scientific Session & Expo)|
|主催者||American College of Cardiology|
|発表者・共同発表者||◎SEKIGUCHI Haruki, WATANABE Erisa, ARASHI Hiroyuki, YAMAGUCHI Junichi, OGAWA Hiroshi, HAGIWARA Nobuhisa|
|学会抄録||Journal of the American College of Cardiology 71(11),Supplement A1757 2018|
|概要||Background: Well-controlled low-density lipoprotein-cholesterol (LDL-C) levels are important for secondary prevention of coronary artery disease, particularly in the setting of acute coronary syndrome (ACS). However, the association between other conventional lipid measures and major cardiovascular adverse events (MACEs) in patients with ACS receiving aggressive lipid-lowering management for dyslipidemia is unknown. We aimed to compare the association between high-density lipoprotein-cholesterol (HDL-C), non-HDL-C, triglycerides (TG) and the LDL-C/HDL-C ratio and MACEs (a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina, or any coronary revascularization) in patients with ACS receiving lipid-lowering therapy.
Methods: This is a sub-analysis of the Heart Institute of Japan-PRoper level of lipid lOwering with Pitavastatin and Ezetimibe in acute coRonary syndrome (HIJ-PROPER) study, which assessed the influence of aggressive LDL-C lowering treatment using statin and ezetimibe in 1734 patients diagnosed with ACS and concomitant dyslipidemia. We performed a log rank analysis of MACEs using blood lipid profiles including HDL-C, non-HDL-C, TG, and the LDL-C/HDL-C ratio.
Results: We studied 1721 patients (mean age 65 ± 12 years, men 75.5%) who were followed-up for 3 years and observed that 599 presented with MACEs. The low LDL-C/HDL-C ratio group (≤ 2.3) showed a significantly lower event rate than the other groups (p[A1] < 0.05). Other components of the lipid profile did not show a significant association with MACEs. Based on the receiver operating characteristic (ROC) curve analysis, the optimal cut-off level for the LDL-C/HDL-C ratio was determined to be 2.5 (sensitivity 67.4%, specificity 38.2%, area under curve 0.544).
Conclusion: Our sub-analysis of data obtained from the HIJ-PROPER study revealed that the LDL-C/HDL-C ratio as compared to other parameters was more strongly associated with MACEs in patients with ACS receiving aggressive lipid-lowering therapy