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We audited 94 serial patients with acute coronary syndrome (ACS) on lipid-lowering
therapy admitted to a coronary care unit in a Perth tertiary hospital to determine
the prevalence of lipid-related residual risk of cardiovascular disease. Twenty-nine
(29) patients presented with ST elevation myocardial infarction (STEMI), 49 with non
ST elevation myocardial infarction (NSTEMI) and 16 with unstable angina. We recorded
fasting plasma low-density lipoprotein cholesterol (LDL-C), triglycerides, lipoprotein
(a) [Lp(a)], and remnant cholesterol (REM-C) concentrations (total cholesterol minus
HDL-C and LDL-C) [
Sixty-six (66) (70.2%) of the patients were male, with 42.6% having premature coronary
artery disease (<60 years of age).
2.
Fifty-one (51) (54.3%) had elevated LDL-C (≥2 mmol/L), and 47 (50%) elevated triglycerides
(≥ 1.7 mmol/L), and 59 (62.8%) reduced HDL-C (<1 mmol/L).
3.
Twenty-nine (29) (30.9%) had elevated plasma Lp(a), (≥105 nmol/L), and 38 (40.4%)
had elevated REM-C, (≥0.9 mmol/L). 13.8% had both elevated Lp(a) and LDL-C, 16.0%
had both elevated LDL-C and REM-C, and 3.2% had both elevated Lp(a) and REM-C. Eight
(8) patients (8.5%) had elevated Lp(a), LDL-C and REM-C. Overall, only 9.6% of the
cohort had optimal levels for LDL-C, triglycerides, HDL-C [
Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular
events: individual patient-data meta-analysis of statin outcome trials.
Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors
to cardiovascular disease and all-cause mortality in 90000 individuals from the general
population.
Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials.
Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and all-cause mortality in 90000 individuals from the general population.
