Rosuvastatin-induced high-density lipoprotein changes in patients who underwent percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome

• Published in: Journal of cardiology Vol. 60; no. 5; pp. 383 - 388
• Main Authors: Yun, Kyeong Ho, MD, Shin, Seoung-Nam, MD, Ko, Jum Suk, MD, Rhee, Sang Jae, MD, Kim, Nam-Ho, MD, Oh, Seok Kyu, MD, Jeong, Jin-Won, MD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-11-2012
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - blood; Acute Coronary Syndrome - therapy; Aged; Cardiovascular; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Electrocardiography; Fluorobenzenes - therapeutic use; Forecasting; High-density lipoprotein; Humans; Hydroxymethylglutaryl-CoA reductase inhibitors; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Incidence; Lipids; Lipoproteins, HDL - blood; Middle Aged; Multivariate Analysis; Percutaneous Coronary Intervention; Prospective Studies; Pyrimidines - therapeutic use; Rosuvastatin Calcium; Sulfonamides - therapeutic use; Time Factors; Lipids; Hydroxymethylglutaryl-CoA reductase inhibitors; High-density lipoprotein; Acute coronary syndrome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2012.07.008

Abstract Background Clinical significance of statin-induced high-density lipoprotein cholesterol (HDL-C) changes is not well known. We investigated the factors affecting rosuvastatin-induced HDL-C changes and their correlation with 12-month major adverse cardiovascular events (MACE) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and percutaneous coronary intervention (PCI). Materials and methods We analyzed 556 consecutive NSTE-ACS patients who underwent PCI and received rosuvastatin 10 mg before discharge. We measured serum lipids, including total cholesterol, triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and HDL-C at baseline and at 4 weeks. The relationship between on-treatment lipid levels, baseline lipid levels, and 12-month MACE was assessed. Results Rosuvastatin treatment increased the mean HDL-C concentration by 1.1 ± 9.8 mg/dl (4.3 ± 23.0%). HDL-C was increased in 312 patients (56.1%), but decreased in 244 patients (43.9%) after statin treatment. Changes in HDL-C during first month were inversely correlated with baseline HDL-C levels ( r = −0.379, p < 0.001). The patients with increased HDL-C showed higher baseline TG levels but lower on-treatment TG levels. Changes in TG were correlated with changes in HDL-C ( r = −0.212, p < 0.001). The incidence of 12-month MACE according to changes in HDL-C was similar between the two groups (11.9% vs. 12.3%, p = 0.875). Multivariate analysis revealed that baseline HDL-C level was the only significant predictor of rosuvastatin-induced HDL-C changes. Conclusion Baseline HDL-C concentration was an independent predictor of rosuvastatin-induced HDL-C changes. Statin-induced HDL-C changes did not predict 12-month MACE in patients with NSTE-ACS.