Real world outcomes of Thai patient with acute coronary syndrome classified by achieved low-density lipoprotein level

Type of funding sources: None.

 Although lower low-density lipoprotein (LDL) level is recommended to improves clinical outcomes, little is known about the association between LDL level after treatment and outcomes in developing countries. The aim of the study was to evaluate the impact of LDL level on mortality rate and outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

 We conducted a single center retrospective study of all patients with a diagnosis of STEMI who underwent primary PCI at a tertiary care hospital in Thailand from 2005-2015. Patients were classified by LDL level at 3 months after discharge. Characteristics, treatments, and outcomes were gathered. T-­test, and Chi-­square were used to analyze.

 A total of 983 patients with STEMI who had undergone PPCI were identified STEMI. Of those, 418 patients had available follow LDL level at 3 months and were analyzed (mean age 59.9 ± 12.7 years, 27.3% female, 46.8% hypertension, 26.7% diabetes). There were only 32 and 67 patients who had LDL <55 and 55-70 mg/dL, respectively. The 2- year composite endpoint of death, unstable angina, myocardial infarction and stoke were not different between each group (12.5% vs. 14.9% vs. 17.6% for patient achieved LDL <55, <70 and ≥70 mg/dL, respectively; p = 0.69).

 In this single center experience, among patients with STEMI who underwent primary PCI in Thailand, only a quarter of patients achieving LDL level <70 mg/dL, and only 7% of all patient had LDL <55 mg/dL as recommended per international guidelines. The achieved LDL level was not associated better outcome.