Prevalence of low high-density lipoprotein cholesterol (HDL-C) as a marker of residual cardiovascular risk among acute coronary syndrome patients from Oman

Abstract

Objective:

To estimate the prevalence as well as predictors of low high-density lipoprotein cholesterol (HDL-C) levels among acute coronary syndrome (ACS) patients in Oman.

Methods:

Data were analyzed from the records of 1583 consecutive patients admitted with a diagnosis of ACS as part of the Gulf Registry of Acute Coronary Events (Gulf RACE). A low HDL-C was considered as <40 mg/dL for males and <50 mg/dL for females.

Results:

The overall mean age of the cohort was 59 ± 13 years ranging from 19 to 102 with patients being mostly male (62%) and Omani (83%). The majority were on statin therapy (84%) and 1.1% were on fenofibrate. The overall prevalence of low HDL-C for this ACS population in Oman was 53% mostly affecting females (67 vs. 43%; p < 0.001). After covariate adjustment, renal impairment (serum creatinine >2 mg/dL), triglycerides, and body mass index (BMI) were positive predictors of low HDL-C. However, male gender, total cholesterol, and heart failure (Killip class score ≥3) were negative predictors of low HDL-C.

Conclusions:

Omani ACS patients have a high prevalence of low HDL-C. Renal impairment, triglycerides, and BMI were positive predictors of low HDL-C. The clinical relevance of a low HDL-C abnormality needs to be evaluated in light of the study's limitations (e.g., cross sectional study design as well as the effects of the acute phase reaction and treatment).

Key words::

• Acute coronary syndrome
• High density lipoprotein cholesterol
• Low density lipoprotein cholesterol
• Triglycerides
• Oman

Transparency

Declaration of funding

The Gulf RACE registry is a Gulf Heart Association project supported by Sanofi-Aventis, Paris, France, and Qatar Telecommunications Company, Doha, Qatar. The sponsors had no involvement in the study conception or design; collection, analysis, and interpretation of data; writing, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Declaration of financial/other relationships

The author(s) declare no conflicts of interest, financial or otherwise, with respect to the authorship and/or publication of this article. CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

We thank the patients, physicians, nurses, and support staff participating in the Gulf RACE registry for their invaluable cooperation. Furthermore, we would like to acknowledge that the abstract for this study has been submitted and accepted at the International Congress on Prediabetes and the Metabolic Syndrome: Epidemiology, Management and Prevention of Diabetes and Cardiovascular Disease. Madrid, Spain for April 6–9, 2011. We also declare that no assistance in the preparation of this article was sought.