Lipid paradox in XXXX -the association with 30-day in-hospital mortality.

@entity1 @entity583 @entity1674 @entity412 @entity453 @entity1718 @entity165
OBJECTIVES: Elevated low-density lipoprotein @entity165 and @entity1674 are major risk factors for @entity453 . However, @entity1718 from @entity1674 are a major energy source, low-density lipoprotein @entity165 is critical for cell membrane synthesis, and both are critical for cell survival. This study was designed to clarify the relationship between lipid profile, morbidity as assessed by Killip classification, and 30-day mortality in @entity1 with @entity583 . DESIGN: A noninterventional observational study. SETTING: Coronary care unit in a university hospital. @entity1 : Seven hundred twenty-four @entity1 with @entity583 in the coronary care program of the Bureau of Health Promotion were analyzed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Low-density lipoprotein @entity165 and @entity412 levels were significantly lower in high-Killip (III+IV) @entity1 compared with low-Killip (I+II) @entity1 and in those who died compared with those who survived beyond 30 days (both p<0.001). After adjustment for risk factors, low-density lipoprotein @entity165 less than 62.5 mg/dL and @entity1674 less than 110 mg/dL were identified as optimal threshold values for predicting 30-day mortality and were associated with hazard ratios of 1.65 (95% CI, 1.18-2.30) and 5.05 (95% CI, 1.75-14.54), and the actual mortality rates were 23% in low low-density lipoprotein, 6% in high low-density lipoprotein, 14% in low @entity1674 , and 3% in high @entity1674 groups, respectively. To test the synergistic effect, high-Killip @entity1 with @entity1674 less than 62.5 mg/dL and low-density lipoprotein @entity165 less than 110 mg/dL had a 10.9-fold higher adjusted risk of mortality than low-Killip @entity1 with @entity1674 greater than or equal to 62.5 mg/dL and low-density lipoprotein @entity165 greater than or equal to 110 mg/dL (p<0.001). The lipid paradox also improved @entity583 short-term outcomes prediction on original Killip and thrombolytic in @entity583 scores. CONCLUSIONS: Low low-density lipoprotein @entity165 , low @entity1674 , and high Killip severity were associated with significantly higher 30-day in-hospital mortality in @entity1 presenting with @entity583 . The initial lipid profile of @entity1 with @entity583 may therefore hold prognostic value.
