The association between an elevated...

The association between an elevated cholesterol horizontal and adverse outcomes in the somewhat old is controversial. Some investigators have erect an association between a subdued cholesterol level and increased mortality in older men No inquiry has correlated cholesterol levels, as measured during acute coronary marked occurrences and long-term clinical outcomes. Foody and associates hypothesize that if total cholesterol evens measured during hospitalization have prognostic value, the strongest association with cardiovascular facts in patients would be fix in those at highest risk for these occurrences such as older patients who have had acute myocardial infarction (AMI).

The researchers administrationed this study to determine whether total cholesterol evens measured during hospitalization for AMI are an independent prognostic factor for all-cause mortality in an older cohort of individuals who survived an AMI.

The application of mind sample consisted of chart reviews from the Cooperative Cardiovascular exhibit (CCP) pilot. Patients were at least 65 years of age, with a clinically confirmed AMI. The total serum cholesterol horizontal was measured, and demographic and clinical information were recorded. The result variable was all-cause mortality within six years of discharge.

Of the 16182 hospitalizations in the CCP pilot, 4923 met inclusion criteria for the research and had in-hospital measurement of cholesterol flats Of these patients, 22 percent had a cholesterol on a level of at least 240 mg by dL (6.2 mmol per L) barely 6 percent of patients were discharged with a prescription for a lipid-lowering medication.

No association was plant between elevated cholesterol level and higher all-cause mortality. Of patients who survived an AMI and had a cholesterol flat greater than 240 mg for dL, 17.2 percent died within undivided year, and 47.9 percent died within six years, compared with 174 and 487 percent respectively, of patients with cholesterol of the same heights lower than 240 mg through dL. At six-year follow-up, all-cause mortality was not significantly associated with cholesterol plain There was a slight, nonsignificant inclination toward increased mortality in patients with highly low cholesterol levels. These be the effects were not altered when excluding patients discharged with lipid-lowering agents.

In this cohort of patients, neither high nor cheap cholesterol levels obtained during hospitalization for AMI were associated with all-cause mortality at six years. like measurements in this cohort of patients did not provide prognostic information that is useful in risk stratification. This subject of attention analyzed cholesterol measurements performed early after AMI. Thus, on a level though cholesterol levels can small quantity markedly after AMI, the evens studied are likely to be a reasonable approximation of patients' usual levels

The authors caution that their findings apply sole to total cholesterol levels. Fractionated on a levels were not available for review, and lipid subfractions may provide prognostic information.

Foody JM et al. Long-term prognostic importance of total cholesterol in somewhat old survivors of an acute myocardial infarction: the cooperative cardiovascular pilot shoot forward J Am Geriatr Soc July 2003;51:930-6

COPYRIGHT 2004 American Academy of Family Physicians

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