Changes in serum cholesterol levels determine future risk of cardiovascular events in patients with acute coronary syndrome in the Japanese Coronary Artery Disease (JCAD) Study

BackgroundAlthough increased attention is given to assess absolute values of serum cholesterol profiles as optimal markers for preventing future cardiovascular (CV) events, changes in cholesterol profiles also have the potential to be associated with CV disease outcome in Japanese patients with acute coronary syndrome (ACS).MethodsFrom the database of the Japanese Coronary Artery Disease (JCAD) study, 2664 patients with ACS who had serial measurements of serum cholesterol profile parameters were enrolled. These patients were followed-up for a mean period of 2.7 years. The endpoint was all CV events. Baseline clinical characteristics of patients with and without CV events were adjusted by the propensity score matching analysis.ResultsNone of the serum absolute cholesterol profiles at baseline and 6 months later was associated with CV events, except for baseline serum total cholesterol level. However, large improvements in cholesterol profiles correlated with better CV disease outcome.ConclusionsThis subanalysis of JCAD demonstrated the importance of serial assessment of serum cholesterol profiles for secondary prevention of CV events in Japanese patients with ACS. Changes in serum cholesterol profiles, rather than their absolute values, correlated with future CV events.