Prevalence of Elevated Low-Density Lipoprotein Cholesterol and Reduced High-Density Lipoprotein Cholesterol among Statin-Naïve Patients Presenting with Acute ST-Segment Elevation Myocardial Infarction: A Hospital-Based Cross-Sectional Study

Abstract

Objectives: To determine the prevalence of elevated low-density lipoprotein cholesterol (LDL-C) and reduced high-density lipoprotein cholesterol (HDL-C) among statin-naïve patients presenting with acute ST-segment elevation myocardial infarction (STEMI). Methodology: This hospital-based cross-sectional study was conducted in the Department of Cardiology, Jinnah Hospital, Lahore, Pakistan, between March 1 and August 31, 2023. Following institutional ethical approval, 90 consecutive statin-naïve patients diagnosed with acute STEMI according to predefined eligibility criteria were enrolled after obtaining written informed consent. Blood samples for lipid profile analysis were collected immediately after hospital admission under non-fasting conditions and before initiation of lipid-lowering therapy. Elevated LDL-C (≥130 mg/dL) and reduced HDL-C (<40 mg/dL) were defined according to the prespecified study protocol. Results: Ninety statin-naïve patients with acute STEMI were included in the final analysis. The mean age was 54.53 ± 13.84 years, and 63.3% of participants were male. Elevated LDL-C was identified in 36 patients (40.0%; 95% CI: 29.9–50.1%), while reduced HDL-C was observed in 42 patients (46.7%; 95% CI: 36.4–57.0%). Mean LDL-C and HDL-C concentrations were 133.10 ± 32.87 mg/dL and 37.53 ± 9.19 mg/dL, respectively. Exploratory unadjusted analyses demonstrated significant associations between elevated LDL-C and hypertension, diabetes mellitus, smoking status, and BMI, whereas reduced HDL-C showed a significant association with diabetes mellitus and a borderline association with BMI. Conclusion: Elevated LDL-C and reduced HDL-C were common among statin-naïve patients presenting with acute STEMI. These findings demonstrate a substantial burden of lipid abnormalities at initial presentation and support routine early lipid profile assessment following acute myocardial infarction to facilitate guideline-directed secondary prevention.