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Clinical Investigations: CARDIOLOGY |

Effect of Acute Myocardial Infarction on Cholesterol Ratios*

Norrapol Wattanasuwan, MD; Ijaz A. Khan, MD, FCCP; Ramesh M. Gowda, MD; Balendu C. Vasavada, MD; Terrence J. Sacchi, MD
Author and Funding Information

*From the Divisions of Cardiology, Long Island College Hospital (Drs. Wattanasuwan, Gowda, Vasavada, and Sacchi), Brooklyn, NY; and Creighton University School of Medicine (Dr. Khan), Omaha, NE.

Correspondence to: Ijaz A. Khan, MD, FCCP, Creighton University Cardiac Center, 3006 Webster St, Omaha, NE 68131-2044; e-mail: ikhan@cardiac.creighton.edu



Chest. 2001;120(4):1196-1199. doi:10.1378/chest.120.4.1196
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Objective: In patients with acute myocardial infarctions (MIs), cholesterol levels are no longer valid after 24 h from presentation because acute MI causes a rapid decline in serum levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. The objective of this study was to evaluate the effect of acute MI on the total cholesterol/HDL cholesterol ratio and the LDL cholesterol/HDL cholesterol ratio.

Methods: The study consisted of 45 patients who were admitted to the hospital with acute MIs. Serum levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were determined on day 1 post-MI and day 4 post-MI. The total cholesterol/HDL cholesterol ratio and the LDL cholesterol/HDL cholesterol ratio were calculated. Serum lipid levels and cholesterol ratios were compared between day 1 post-MI and day 4 post-MI.

Results: From day 1 post-MI to day 4 post-MI, the mean (± SD) serum levels of total cholesterol (188.4 ± 52.5 vs 170.5 ± 57.2 mg/dL, respectively; p = 0.01), LDL cholesterol (120.3 ± 48.9 vs 105.9 ± 43.0 mg/dL, respectively; p = 0.009), and HDL cholesterol (45.0 ± 18.5 vs 39.3 ± 16.1 mg/dL, respectively; p < 0.001) decreased, but the mean serum level of triglycerides (119.2 ± 81.2 vs 149.3 ± 68.3 mg/dL, respectively; p = 0.006) increased. The cholesterol ratios, however, remained unchanged between day 1 post-MI and day 4 post-MI. The total cholesterol/HDL cholesterol ratio was 4.59 ± 1.84 on day 1 post-MI and 4.67 ± 1.77 on day 4 post-MI (change not significant). The LDL cholesterol/HDL cholesterol ratio was 2.96 ± 1.58 on day 1 post-MI and 2.99 ± 1.44 on day 4 post-MI (change not significant).

Conclusion: Acute MI does not affect the cholesterol ratios. Therefore, when the absolute levels of serum cholesterol are no longer valid (beyond 24 h after an MI), the cholesterol ratios still could be useful for cholesterol risk assessment in patients with acute MIs.


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