Non-HDL-C is associated with the occurrence of acute myocardial infarction in Chinese populations with diabetes

Abstract Background: Non-HDL-C has been associated with the prognosis and long-term prognosis of acute myocardial infarction, but the association between non-HDL-C and the occurrence of acute myocardial infarction in the Chinese population remains unclear. The purpose of this study is to explore whether non-HDL-C is related to the occurrence of acute myocardial infarction in the Chinese, and to further explore its relationship with the occurrence of acute myocardial infarction in subjects with diabetes.Methods and Results: We reviewed the medical records of patients who visited the Department of Cardiology at the First Affiliated Hospital of the University of South China from May 1, 2012 to September 30, 2020. According to inclusion and exclusion criteria, 6558 subjects were included in the non-AMI group and 3386 subjects were included in the AMI group. In the entire population, non-HDL-C was associated with the incidence of acute myocardial infarction, regardless of adjustment for confounding factors. In non-diabetic patients, non-HDL-C, HDL-C, LDL-C was found to be associated with the occurrence of acute myocardial infarction. In subjects with diabetes, non-HDL-C was associated with AMI without adjusting for confounding factors (Model 1) (OR: 1.268, 95%CI 1.035-1.547, P=0.022), and LDL-C was not associated with AMI (OR: 1.129, 95%CI 0.904 -- 1.411, P=0.286), HDL-C was negatively correlated with the incidence of acute myocardial infarction (OR: 0.577, 95%CI 0.418 -- 0.796, P < 0.001). After adjusting for age and sex (Model 2), non-HDL-C was positively correlated with the incidence of acute myocardial infarction (OR: 1.371, 95%CI 1.103-1.704, P=0.004), while the correlation between HDL-C and LDL-C and acute myocardial infarction was not observed. After adjusting for age, sex, hypertension/smoking, and BMI (Model 3), non-HDL-C was positively correlated with the incidence of acute myocardial infarction (OR: 1.381, 95%CI 1.103-1.728, P=0.005), and no correlation was observed between HDL-C and LDL-C and acute myocardial infarction.Conclusions：In subjects with diabetes, after adjusting for confounders associated with coronary heart disease, non-HDL-C was found to be associated with AMI, whereas HDL-C and LDL-C were not associated with AMI. In addition, non-HDL-C can also be found to be related to the occurrence of acute myocardial infarction in patients without diabetes.