A large population-based cohort from Denmark showed that cholesterol levels are more strongly associated with STEMI than to NSTEMI in statin-treated patients. The findings were presented at the European Society of Cardiology Congress (ESC) 2025. While both conditions are forms of myocardial infarction, STEMI is associated with higher early mortality.
The study included 36,739 patients with ischemic heart disease identified in the Western Denmark Heart Registry. LDL-C and non-HDL-C levels were measured within one year after coronary angiography. Over a median follow-up of 4.9 years, 531 STEMI and 1,614 NSTEMI events occurred.
STEMI was linked to higher 30-day mortality than NSTEMI, with an adjusted odds ratio of 1.62 (95% CI: 1.02–2.57). Each 1 mmol/L higher LDL-C increased the hazard ratio for STEMI by 1.43 compared with 1.23 for NSTEMI, corresponding to 18% higher odds of STEMI versus NSTEMI. Patients who achieved the LDL-C goal of ≤1.4 mmol/L had lower risks of both MI types, including 22% lower odds of STEMI compared with NSTEMI. Results were consistent for non-HDL-C.
These findings indicate that intensive cholesterol lowering is particularly important for reducing STEMI risk. The study improves preventive strategies in statin-treated patients with ischemic heart disease.
