Patients with low high-density lipoprotein-cholesterol or smoking are more likely to develop myocardial infarction among subjects with a visible lesion or stenosis in coronary artery

Background Traditional contrast coronary arteriography affords only an indirect view of aspects of atheromata related to their propensity to trigger thromboses, so it is urgent to recognize the vulnerable person who is more likely to develop myocardial infarction (MI) among patients with visible lesion or stenosis in coronary artery. Methods and Results Two hundred and eighty-eight patients (144 MI patients, 144 controls) who had either a visible lesion or differing extent of stenosis in I or more major coronary arteries were consecutively enrolled. Lipid profile, C-reactive protein (CRP), smoking, hypertension, dyslipidemia and diabetes were analyzed for their association with MI. No differences in the prevalence of dyslipidemia, hypertension or diabetes was found between the patients with MI and those without, and CRP, triglycerides, total cholesterol and low-density lipoprotein-cholesterol levels did not differ between the 2 groups (all p > 0.05). However, high-density lipoprotein-cholesterol (HDL-C) was significantly lower in the patients with MI than in those without (1.06 +/- 0.30 vs 1.14 +/- 0.32 mmol/L, p = 0.024). On multivariate analysis after adjustment for age and gender, adjusted odds ratio (95% confidence interval) of MI was 0.44 (0.20-0.96) for HDL-C, p = 0.038; 2.6 (1.48-4.56, p = 0.001) for smoking, which indicated that high HDL-C was protective for MI, and smoking was associated with an increased risk of MI. Conclusions The present findings indicate that among subjects with a visible lesion or stenosis in coronary arteries, those with low HDL-C or smokers are more likely to develop MI.