Cholesterol levels in heart attack patients didn't indicate any risk

Washington, Jan 14: Nearly 75 percent of patients hospitalised for a heart attack had cholesterol levels that did not signify high risk for a cardiovascular event, according to a new study.

Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal.

"Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit," said Gregg C. Fonarow.

Fonarow is professor of cardiovascular medicine at the David Geffen School of Medicine at University of California Los Angeles (UCLA) and the study's principal investigator.

The research team used a national database sponsored by the American Heart Association's Get with the Guidelines programme. The database includes information on patients hospitalised for cardiovascular disease at 541 hospitals across the country.

Researchers analysed data from 1,36,905 patients hospitalised for a heart attack nationwide between 2000 and 2006 whose lipid levels upon hospital admission were documented. This accounted for 59 percent of total hospital admissions for heart attack at participating hospitals during the study period.

Researchers also found that more than half of such hospitalised patients had poor high-density lipoprotein (HDL) cholesterol levels, according to national guidelines.

The study suggests that lowering guideline targets for LDL cholesterol for those at risk for cardiovascular disease, as well as developing better treatments to raise HDL cholesterol, may help reduce the number of patients hospitalised for heart attack in future.

"The study gives us new insight and intervention ideas to help reduce the number of heart attacks," said Fonarow, who is also director of the Ahmanson-UCLA Cardiomyopathy Centre.

"This is one of the first studies to address lipid levels in patients hospitalised for a heart attack at hospitals across the entire country."

The study also showed that HDL cholesterol, or "good cholesterol", levels have dropped in patients hospitalised for heart attack over the past few years, possibly due to increasing rates of obesity, insulin resistance and diabetes, said an UCLA release.

Fonarow also noted that only 21 percent of patients in the study were taking lipid-lowering medications before admission, despite almost half having a prior history of cardiovascular events, which would prompt treatment.

These findings were published in the January issue of the American Heart Journal.