AIMS Elevated maternal cholesterol during pregnancy (MCP) enhances atherogenesis in childhood, but its possible impact on acute myocardial infarction (AMI) in adults is unknown. METHODS AND RESULTS We retrospectively evaluated 310 patients who were admitted to hospital and whose MCP data were retrievable. Eighty-nine AMI patients with typical chest pain, transmural infarction Q-waves, elevated creatinine kinase, and 221 controls hospitalized for other reasons were identified. The AMI cohort was classified by MI severity (severe = involving three arteries, left ventricle ejection fraction ≤35, CK-peak >1200 mg/dL, or CK-MB >200 mg/dL). The association of MCP with AMI severity was tested by linear and multiple regression analysis that included conventional cardiovascular risk factors, gender, age, and treatment. Associations of MCP with body mass index (BMI) in patients were assessed by linear correlation. In the AMI cohort, MCP correlated with four measures of AMI severity: number of vessels (β = 0.382, P = 0.001), ejection fraction (β = -0.315, P = 0.003), CK (β = 0.260, P = 0.014), and CK-MB (β = 0.334, P = 0.001), as well as survival time (β = -0.252, P = 0.031). In multivariate analysis of patients stratified by AMI severity, MCP predicted AMI severity independently of age, gender, BMI, and CHD risk factors (odds ratio = 1.382, 95% confidence interval 1.046-1.825; P = 0.023). Survival was affected mainly by AMI severity. CONCLUSIONS Maternal cholesterol during pregnancy is associated with adult BMI, atherosclerosis-related risk, and severity of AMI.

中文翻译：

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孕期母体高胆固醇血症影响年轻成人心肌梗塞的严重程度。

目的 妊娠期母体胆固醇 (MCP) 升高会增强儿童期的动脉粥样硬化形成，但其对成人急性心肌梗死 (AMI) 的可能影响尚不清楚。方法和结果 我们回顾性评估了 310 名入院且 MCP 数据可检索的患者。确定了 89 名具有典型胸痛、透壁梗塞 Q 波、肌酐激酶升高的 AMI 患者和 221 名因其他原因住院的对照。AMI 队列按 MI 严重程度分类（严重 = 涉及三支动脉，左心室射血分数 ≤35，CK 峰值 >1200 mg/dL，或 CK-MB >200 mg/dL）。通过线性和多元回归分析测试 MCP 与 AMI 严重程度的关联，包括常规心血管危险因素、性别、年龄和治疗。通过线性相关评估MCP与患者体重指数（BMI）的关联。在 AMI 队列中，MCP 与 AMI 严重程度的四个指标相关：血管数量 (β = 0.382, P = 0.001)、射血分数 (β = -0.315, P = 0.003)、CK (β = 0.260, P = 0.014) , 和 CK-MB (β = 0.334, P = 0.001), 以及生存时间 (β = -0.252, P = 0.031)。在按 AMI 严重程度分层的患者的多变量分析中，MCP 独立于年龄、性别、BMI 和 CHD 危险因素预测 AMI 严重程度（优势比 = 1.382，95% 置信区间 1.046-1.825；P = 0.023）。存活率主要受 AMI 严重程度的影响。结论：妊娠期母体胆固醇与成人 BMI、动脉粥样硬化相关风险和 AMI 严重程度相关。MCP 与 AMI 严重程度的四个指标相关：血管数量 (β = 0.382, P = 0.001)、射血分数 (β = -0.315, P = 0.003)、CK (β = 0.260, P = 0.014) 和 CK-MB (β = 0.334, P = 0.001)，以及生存时间 (β = -0.252, P = 0.031)。在按 AMI 严重程度分层的患者的多变量分析中，MCP 独立于年龄、性别、BMI 和 CHD 危险因素预测 AMI 严重程度（优势比 = 1.382，95% 置信区间 1.046-1.825；P = 0.023）。存活率主要受 AMI 严重程度的影响。结论：妊娠期母体胆固醇与成人 BMI、动脉粥样硬化相关风险和 AMI 严重程度相关。MCP 与 AMI 严重程度的四个指标相关：血管数量 (β = 0.382, P = 0.001)、射血分数 (β = -0.315, P = 0.003)、CK (β = 0.260, P = 0.014) 和 CK-MB (β = 0.334, P = 0.001)，以及生存时间 (β = -0.252, P = 0.031)。在按 AMI 严重程度分层的患者的多变量分析中，MCP 独立于年龄、性别、BMI 和 CHD 危险因素预测 AMI 严重程度（优势比 = 1.382，95% 置信区间 1.046-1.825；P = 0.023）。存活率主要受 AMI 严重程度的影响。结论：妊娠期母体胆固醇与成人 BMI、动脉粥样硬化相关风险和 AMI 严重程度相关。P = 0.031）。在按 AMI 严重程度分层的患者的多变量分析中，MCP 独立于年龄、性别、BMI 和 CHD 危险因素预测 AMI 严重程度（优势比 = 1.382，95% 置信区间 1.046-1.825；P = 0.023）。存活率主要受 AMI 严重程度的影响。结论：妊娠期母体胆固醇与成人 BMI、动脉粥样硬化相关风险和 AMI 严重程度相关。P = 0.031）。在按 AMI 严重程度分层的患者的多变量分析中，MCP 独立于年龄、性别、BMI 和 CHD 危险因素预测 AMI 严重程度（优势比 = 1.382，95% 置信区间 1.046-1.825；P = 0.023）。存活率主要受 AMI 严重程度的影响。结论：妊娠期母体胆固醇与成人 BMI、动脉粥样硬化相关风险和 AMI 严重程度相关。