CHANGES IN PLASMA-CHOLESTEROL LEVELS AFTER HOSPITALIZATION FOR ACUTE CORONARY EVENTS

To retrospectively assess the changes in total cholesterol levels afte r a hospital admission for an acute coronary event, 287 patients were identified who had one isolated event: 130 patients with acute myocard ial infarction, 122 patients after coronary artery bypass graft surger y, 35 patients after percutaneous transluminal coronary angioplasty. T o be included, patients had to have a total cholesterol measurement wi thin the 3 months prior to hospitalization and periodically after the acute coronary event. Total cholesterol measurements were recorded dur ing four time periods: 0-3 months before hospital admission (baseline) ; and 0-3, 3-6, and 6-9 months after the hospitalization. Mean total c holesterol value was used if a patient had multiple measurements durin g a time period. Results: There was no significant difference in the b aseline total cholesterol levels among the three groups (acute myocard ial infarction, coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty). In all three groups, there was a d ecrease in total cholesterol level after hospital admission compared t o baseline (p < 0.0001). This decrease was significantly greater in co ronary artery bypass graft surgery patients compared to the other two groups. Total cholesterol levels returned to baseline levels by 3 mont hs after the hospitalization in all three groups. Total cholesterol de creased significantly from baseline in patients after an acute myocard ial infarction; this decrease was significantly greater if they receiv ed thrombolytic therapy (p < 0.05). Total cholesterol returned to base line 3 months after hospitalization in both groups. Conclusions: Durin g the 3 months following hospital admission for an acute coronary even t, total cholesterol levels are not representative of the patient's ba seline values. Management of hypercholesterolemia in this setting requ ires the use of baseline (preadmission) total cholesterol values.