PROGNOSTIC VALUE OF SERUM-CHOLESTEROL LEVEL IN JAPANESE PATIENTS WITHCORONARY-ARTERY DISEASE

To determine the prognostic value of serum cholesterol level in Japane se patients with established coronary artery disease, we followed 330 consecutive patients with a left ventricular ejection fraction of grea ter than or equal to 50%. Over a period of 4.0+/-2.5 years, 53 patient s (16%) experienced cardiac events. Multivariate analysis using Cox pr oportional hazard modeling revealed that obesity (risk ratio 4.3; p=0. 0001), the number of diseased vessels (risk ratio 1.9; p=0.0001) and a serum cholesterol level greater than or equal to 220 mg/dl (risk rati o 2.3; p=0.01) or greater than or equal to 200 mg/dl (risk ratio 2.1; p<0.02) increase the risk of cardiac events. These results suggest tha t patients with established coronary artery disease and a serum choles terol level greater than or equal to 200 mg/dl have a similar risk of experiencing a cardiac event as patients without left ventricular dysf unction and a serum cholesterol level greater than or equal to 220 mg/ dl. Although the prevalence of coronary artery disease is low in Japan , the serum cholesterol level should be strictly controlled in subject s with established coronary artery disease to avoid future cardiac eve nts.