Abstract 16364: The Lipid Paradox: Lowest Level of LDL-C Associated with Increased In-Hospital Mortality in Patients Following Acute Myocardial Infarction

Background: Lipoprotein levels are recognized as independent risk factors for long-term cardiovascular (CV) events in patients with acute myocardial infarction (AMI). During the acute phase reaction following AMI, previous studies have reported trends of decreased LDL-C, increased triglycerides (TG), and variable HDL-C levels, often proportional to the severity of myocardial necrosis. However, the association between LDL-C and HDL-C levels and in-hospital mortality has not been well established. Methods: NRMI 4-5 records from 2002 to 2006 were analyzed in patients hospitalized for AMI with lipid samples measured within 24 h of presentation. The relationship between lipid levels and in-hospital all-cause mortality was evaluated using multivariable-adjusted logistic regression models. Results: Lipid levels were measured in 114 584 patients with mean LDL-C 104.3 ± 37.7, HDL-C 40.6 ± 13.6, and TG 150.0 ± 97.4 (mg/dL). Compared with the lowest quartile of LDL-C (<77 mg/dL), there was a lower risk of in-hospita...