Prognostic value of serum cholesterol level in Japanese patients with coronary artery disease.

To determine the prognostic value of serum cholesterol level in Japanese patients with established coronary artery disease, we followed 330 consecutive patients with a left ventricular ejection fraction of > or = 50%. Over a period of 4.0 +/- 2.5 years, 53 patients (16%) experienced cardiac events. Multivariate analysis using Cox proportional 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 > or = 220 mg/dl (risk ratio 2.3; p = 0.01) or > or = 200 mg/dl (risk ratio 2.1; p < 0.02) increase the risk of cardiac events. These results suggest that patients with established coronary artery disease and a serum cholesterol level > or = 200 mg/dl have a similar risk of experiencing a cardiac event as patients without left ventricular dysfunction and a serum cholesterol level > or = 220 mg/dl. Although the prevalence of coronary artery disease is low in Japan, the serum cholesterol level should be strictly controlled in subjects with established coronary artery disease to avoid future cardiac events.