A very high prevalence of low HDL cholesterol in Spanish patients with acute coronary syndromes

Clin Cardiol. 2010 Jul;33(7):418-23. doi: 10.1002/clc.20774.


Background: Total and low-density lipoprotein cholesterol (LDL-C) concentrations in coronary artery disease have progressively declined, although high-density lipoprotein cholesterol (HDL-C) has not always been evaluated. The prevalence and related factors of low HDL-C in a cohort of Spanish patients with acute coronary syndromes (ACS) were assessed.

Methods: Clinical and laboratory data registered at admission and at discharge of 648 patients admitted to coronary care units of 6 Spanish hospitals for ACS between January 2004 and September 2007 were analyzed.

Results: Low HDL-C (HDL-C < 1.04 mmol/L) was observed in 367 (56.6%) patients. Male gender, smoking, hypertension, diabetes, high body mass index, and triglycerides were related to low HDL-C. Female gender was the strongest protective factor against low HDL-C (0.619; 95% confidence interval [CI]: 0.410-0.934; P = 0.022), whereas high triglycerides (1.653; 95% CI: 1.323-2.064; P < 0.001) followed by previous ischemic disease (1.504; 95% CI: 1.073-2.110; P = 0.018) were the strongest factors associated with low HDL-C. One-third of patients were taking statins at admission, but only 2% were on fibrate therapy. A large increase in statin therapy, but not in other hypolipemiant drug therapy, between admission and discharge was noted in the whole cohort and among patients with low HDL-C.

Conclusion: Spanish patients with ACS have a very high prevalence of low HDL-C. Male gender, high triglycerides, and previous ischemic disease are strong, independent factors associated with this disorder. As low HDL-C remains almost completely untreated in ACS, strategies to enhance the treatment of this lipoprotein abnormality are urgently required.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / epidemiology*
  • Aged
  • Biomarkers / blood
  • Chi-Square Distribution
  • Cholesterol, HDL / blood*
  • Down-Regulation
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy
  • Dyslipidemias / epidemiology*
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Ischemia / epidemiology
  • Patient Admission
  • Patient Discharge
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Spain / epidemiology
  • Time Factors
  • Triglycerides / blood


  • Biomarkers
  • Cholesterol, HDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Triglycerides