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The Role of Small Dense Low-Density Lipoprotein Cholesterol in the Prediction of Acute Myocardial Infarction


 Background: Acute myocardial infarction (AMI) is a common acute and severe cardiovascular disease. A growing body of evidence suggests that small dense low-density lipoprotein cholesterol (sdLDL-C) is associated with an increased risk of cardiovascular disease. This study aimed to evaluate the predictive value of different lipid indicators, particularly sdLDL-C, in the assessment of AMI.Methods: We retrospectively reviewed the hospital database for all consecutive participants who underwent coronary angiography due to the experience of chest pain in our hospital from September 2019 to June 2020. The basic demographic and clinical data and laboratory assay results for all participants were collected and evaluated at admission. Statistical analysis was performed using SPSS version 26.0.Results: A total of 216 patients with AMI, 154 patients with unstable angina pectoris (UAP) and 103 healthy subjects were included. The levels of LDL3-7 were significantly different among the three groups (P<0.05). Significant positive correlations were observed between the Gensini score and several variables, including hypertension and levels of glucose, sdLDL-C, TC, and LDL-C (r > 0.1, P < 0.001). The sdLDL-C level in the AMI group was significantly higher than that in the control group in individuals with normal LDL-C (P < 0.001). Based on the receiver operating characteristic (ROC) curves, the area under the curve (AUC) of sdLDL-C for AMI risk was 0.666, which was better than that of other lipids. Multivariate logistic regression analysis demonstrated that the sdLDL-C level was significantly correlated with AMI. A logistic regression model were established based on sdLDL-C and other variables to identify people at high cardiovascular risk, with an AUC of 0.868.Conclusions: Increased sdLDL-C level was an independent risk factor for AMI. sdLDL-C may be a useful parameter for the assessment of AMI and help clinicians classify high-risk cardiovascular disease.