Lipid profile during the first 24 hours after myocardial infarction has significant prognostic value.

Aims: A high level of total cholesterol and LDL-cholesterol disturbs the endothelial function. Thus it can be expected, that hypercholesterolaemia may unfavourably influence the course of the acute myocardial infarction. The aim of the study was to check whether patients with lipid levels above normal during the first hours of myocardial infarction have an unfavourable clinical outcome.

Methods And Results: The study group consisted of 348 patients (216 males, aged 65.7+/-12 years) with acute myocardial infarction hospitalized up to 24 hours after the onset of symptoms. Blood samples for lipid profile were taken on the first day of hospitalization, in the morning, while fasting. 109 (31%) patients had a complicated in-hospital course of infarction (i.e. death, recurrent ischaemia, serious arrhythmias and/or conduction disturbances, heart failure). The total cholesterol and LDL-cholesterol levels were higher in the patients with complicated than in the patients with uncomplicated clinical course of infarction: 243+/-40.7 vs 211.2+/-40.6 mg/dl, p<0.001 and 156+/-35.0 vs 132.6+/-35.2 mg/dl p<0.001, respectively.

Conclusions: Higher levels of total cholesterol and LDL cholesterol during the first 24 hours of acute myocardial infarction have a strong negative prognostic value, what suggests the use of statins as early as possible in acute myocardial infarction.