Aneurysmal bone cysts (ABCs) are locally destructive, blood-filled benign bone lesions traditionally regarded as reactive rather than true neoplastic lesions. ABCs typically affect the proximal humerus, distal femur, proximal tibia, and spine. Involvement of the calcaneus is rare, representing approximately 1.6
Background There are limited data on contemporary lipid management practices after acute myocardial infarction (AMI) in Japan and on factors associated with achieving the low-density lipoprotein cholesterol (LDL-C) target recommended by current Japanese guidelines (<70 mg/dL). Methods We retrospectively analyzed 2984 patients with AMI treated at tertiary percutaneous coronary intervention–capable centers in Kanagawa, Japan. Serial LDL-C levels were assessed at baseline, 3 months, and 1 year. Multivariable logistic regression analysis was performed to identify factors associated with achieving LDL-C < 70 mg/dL at 1 year. Results The mean age was 69.5 years, and approximately three-quarters of the patients were male. At discharge, only 3.6% of patients were prescribed high-intensity statin therapy according to the American College of Cardiology and the American Heart Association definition, whereas 41.5% were categorized as high-intensity according to the Japan Atherosclerosis Society definition. At 3 months, the mean LDL-C level decreased to 67.3 mg/dL, and approximately 60% of patients achieved LDL-C < 70 mg/dL; this proportion was maintained through 1 year. Factors independently associated with achieving LDL-C < 70 mg/dL at 1 year included absence of baseline dyslipidemia (OR, 1.31; 95% CI, 1.05–1.65), baseline LDL-C levels (OR, 0.99; 95% CI, 0.99–1.00), ST-segment elevation myocardial infarction (OR, 1.53; 95% CI, 1.19–1.96), use of moderate- or high-intensity statins (OR, 2.37; 95% CI, 1.79–3.15), and ezetimibe prescription (OR, 1.95; 95% CI, 1.51–2.52). Conclusions Although approximately 60% of patients achieved the current LDL-C target, this proportion may be insufficient in light of the anticipated transition toward a lower LDL-C threshold (<55 mg/dL) proposed in recent Japanese scientific statements and aligned with contemporary international guidelines. Early intensification of lipid-lowering therapy, including high-intensity statins and ezetimibe, may be warranted in selected patients to optimize secondary prevention.
