Exploring the Role of Non-HDL Cholesterol in Acute Coronary Syndrome: A Case-Control Study

Abstract

Objectives: This case-control study aimed to investigate the association between non-high-density lipoprotein (non-HDL) cholesterol levels and acute coronary syndrome (ACS) among individuals not recently treated with statins. Methodology: A total of 100 participants with ACS, who had not received recent statin therapy, were selected from the Coronary Care Unit (CCU) at Al-Kadhimiyah Hospital in Baghdad, Iraq. Controls, matching the eligibility criteria of cases except for ACS symptoms, were randomly chosen from the same hospital. Both groups met criteria including age over 40, and a history of diabetes mellitus, hypertension, smoking, and obesity. Statistical significance was set at p < 0.05. Results: The study found a significant independent association between elevated non-HDL cholesterol levels and ACS, with an average non-HDL level of 154.2 mg/dl (normal: 130 mg/dl) among ACS cases (p < 0.001), compared to 120 mg/dl in controls. Elevated non-HDL levels were also correlated with increased BMI (p = 0.01, r = 0.3) and various lipid markers (p < 0.05), except HDL. Conclusion: Elevated non-HDL cholesterol levels upon admission may serve as a potential indicator of ACS risk. These findings underscore the importance of non-HDL cholesterol assessment in ACS risk stratification and management.