Cholesterol levels drop after myocardial infarction
A recent study suggests that lipids should be measured routinely on admission in acute coronary syndromes.
LONDON, September 4 (SPIS MedWire). Results from the LATIN (Lipid Assessment Trial Italian Network) demonstrate that cholesterol levels drop shortly after the onset of a myocardial infarction (MI), and may also be associated with the size of the infarct. DiChiara and colleagues conducted the LATIN study to determine the variation in lipid levels through the course of acute MI and unstable angina, and to evaluate the clinical and prognostic value of measurements taken at different times. Between 1998 and 1999 the team enrolled 1275 patients with MI and 589 with unstable angina who presented to 59 coronary care units across Italy. Their data clearly demonstrate a post-admission reduction in both total cholesterol levels and LDL cholesterol, in both sets of patients. The decrease was greatest after a few days, at –7% for total cholesterol and –12% for LDL-C, and became statistically significant (p<0.001) five hours after admission. Further analysis showed that the magnitude of the variation in blood lipid levels was related to infarct size, with twice as large variations seen in patients with large infarcts. The authors used their data to estimate that failure to measure blood lipids on admission leads to 22% of MI patients and 14% of unstable angina patients not subsequently receiving lipid-lowering medication, thereby remaining at increased risk of subsequent cardiovascular events. They conclude: "In order to treat all dyslipidemic patients, cholesterol determination should be done at hospital admission. International guidelines should adopt these results and strongly recommend that blood samples for lipid measurement should be taken at admission."