Analysis Of Association Between Non-high-density Lipoprotein Cholesterol And The Risk Of Acute Myocardial Infarction In Different Populations

Aims : To explore the relationship between non-high density lipoprotein cholesterol and acute myocardial infarction in different populations,and to establish a risk prediction model of acute myocardial infarction.Methods:The subjects were 9944 patients who were admitted to the Department of Cardiology of The First Affiliated Hospital of University of South China from May 1,2012 to September 30,2020.According to the inclusion and exclusion criteria,they were divided into no myocardial infarction group and acute myocardial infarction group.In the no myocardial infarction group,there were 6558 patients with negative coronary angiography;there were 3386 patients in acute myocardial infarction group who met the diagnostic criteria of acute myocardial infarction.The whole sample population is divided into male population and female population according to gender,and the whole sample population is divided into diabetic population and non-diabetic population according to whether they have diabetes or not.Univariate analysis and binary logistic regression analysis were used to analyze the indexes such as age,sex,BMI,hypertension,diabetes,smoking,triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),non-high density lipoprotein cholesterol(Non-HDL-C).Results:1.Compared with the baseline data,there were significant differences in age,sex,hypertension,diabetes,smoking,TG,TC,HDL-C,LDL-C and Non-HDL-C between the two groups in the whole sample population,male population,female population,non-diabetic population and diabetic population(p<0.05),but there was no significant difference in BMI between the two groups(p=0.692).However,there were significant differences in BMI between the two groups among the whole sample population,male population,female population and non-diabetic population(p<0.05).2.In the whole sample population,HDL-C(OR,0.675;95%CI,0.582-0.783,p < 0.001)and Non-HDL-C(OR,1.604;95%CI,1.516-1.698,p < 0.001)were associated with acute myocardial infarction by gradually adjusting the confounding factors(age,sex,BMI,hypertension,diabetes,smoking).3.In the diabetic population without adjusting for confounding factors,HDL-C(OR,0.589;95%CI,0.427-0.814;p < 0.001)and Non-HDL-C(OR,1.403;95%CI,1.250-1.575;p < 0.001)were associated with the occurrence of acute myocardial infarction,but after adjusting for age and sex,only Non-HDL-C(OR,1.495;95%CI,1.321-1.691;p < 0.001)is related to the occurrence of acute myocardial infarction.Further adjustment for hypertension,smoking and BMI also showed that only Non-HDL-C(OR,1.495;95%CI,1.321-1.691;p < 0.001)was associated with acute myocardial infarction.In non-diabetic subjects,HDL-C(OR,0.661;95%CI,0.559-0.783,p < 0.001)and Non-HDL-C(OR,1.673;95%CI,1.534-1.746,p < 0.001)were associated with acute myocardial infarction after adjusting the confounding factors.4.After adjusting for related confounding factors,HDL-C(OR,0.716;95%CI,0.584-0.820,p=0.001)and Non-HDL-C(OR,1.622;95%CI,1.498-1.758,p<0.001)were associated with the occurrence of acute myocardial infarction in male population.In female population,HDL-C(OR,0.646;95%CI,0.499-0.836,p=0.001)and Non-HDL-C(OR,1.555;95%CI,1.415-1.710,p<0.001)are related to the occurrence of acute myocardial infarction.5.Draw a nomogram according to the results of multifactor analysis,quantitatively evaluate the risk of acute myocardial infarction through the nomogram,establish a risk prediction model and verify the internal data,the verification results show that the accuracy of the risk prediction model is 80%.Conclusion:1.In the whole sample population,male population,female population,and non-diabetic population,HDL-C and non-HDL-C were both associated with the occurrence of AMI after gradually adjusting for confounding factors,in which HDL-C was a protective factor for the prevention of AMI and non-HDL-C was a risk factor for AMI.2.In diabetic population,after gradually adjusting confounding factors,it was found that there was no statistically significant difference in HDL between the normal group and the AMI group,but non-HDL-C was still associated with the occurrence of AMI and was a risk factor for the occurrence of AMI.