Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary Intervention
Background: Some individuals who maintain desirable low-density lipoprotein cholesterol (LDL-C) levels still experience the progression of atherosclerosis, which may eventually lead to cardiovascular events. Non-high-density lipoprotein cholesterol (non-HDL-C) levels are quantified to assess residua...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2023-09-01
|
| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/24/9/10.31083/j.rcm2409263 |
| _version_ | 1827805773229457408 |
|---|---|
| author | Chuang Li Kuizheng He Yixing Yang Kuibao Li Mulei Chen Lefeng Wang Yuanfeng Gao Xiaorong Xu |
| author_facet | Chuang Li Kuizheng He Yixing Yang Kuibao Li Mulei Chen Lefeng Wang Yuanfeng Gao Xiaorong Xu |
| author_sort | Chuang Li |
| collection | DOAJ |
| description | Background: Some individuals who maintain desirable low-density lipoprotein cholesterol (LDL-C) levels still experience the progression of atherosclerosis, which may eventually lead to cardiovascular events. Non-high-density lipoprotein cholesterol (non-HDL-C) levels are quantified to assess residual risk in statin-treated patients with coronary heart disease. The study aimed to estimate the predictive performance of discordance between non-HDL-C and LDL-C on clinical prognosis in statin-treated patients with previous coronary artery bypass grafting (CABG). Methods: 468 statin-treated patients with previous CABG undergoing percutaneous coronary intervention (PCI) as a secondary coronary treatment due to acute coronary syndrome (ACS) were retrospectively enrolled in this study. The definition of major adverse cardiovascular events (MACEs) was a composite endpoint of cardiovascular death, recurring myocardial infarction, and a need for repeat revascularization. Cox proportional hazards modeling, restricted cubic splines regression, and discordance analysis were conducted to the association between all lipid parameters and the occurrence of MACEs. Discordant values were defined as LDL-C concentrations ≤1.8 mmol/L accompanied by non-HDL-C >2.6 mmol/L. Results: MACEs occurred in 95 patients over a median follow-up period of 744.5 days. Cox models demonstrated that increased concentrations of non-HDL-C and LDL-C levels were independent risk indicators of MACEs (p < 0.001). The restricted cubic spline analysis revealed a linear relationship between non-HDL-C concentrations and MACEs (p-nonlinear: 0.26), whereas a nonlinear relationship was observed between LDL-C concentrations and MACEs (p < 0.01). In the subgroup analysis, the spline curves revealed that the odds of the individuals with desirable LDL-C levels suffering MACEs emerged when non-HDL-C levels were above 2.07 mmol/L. Individuals who exhibited discordance involving high non-HDL-C/low LDL-C levels had an elevated risk of experiencing MACEs compared to those with concordantly low LDL-C and low non-HDL-C levels [hazard ratios (HRs) = 2.44, 95% confidence interval (CI) = 1.14–5.22, p = 0.02]. Conclusions: Non-HDL-C levels could predict the residual risk of MACEs in ACS patients with previous CABG and statin therapy that underwent percutaneous coronary intervention. A discordance between non-HDL-C and LDL-C in individuals with desirable LDL-C levels could be useful in identifying those with a residual risk of cardiovascular complications. |
| first_indexed | 2024-03-11T21:30:57Z |
| format | Article |
| id | doaj.art-8b2908fd0ecf4439a503e746aaf292f0 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-03-11T21:30:57Z |
| publishDate | 2023-09-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-8b2908fd0ecf4439a503e746aaf292f02023-09-27T09:29:52ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-09-0124926310.31083/j.rcm2409263S1530-6550(23)00985-7Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary InterventionChuang Li0Kuizheng He1Yixing Yang2Kuibao Li3Mulei Chen4Lefeng Wang5Yuanfeng Gao6Xiaorong Xu7Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, ChinaBackground: Some individuals who maintain desirable low-density lipoprotein cholesterol (LDL-C) levels still experience the progression of atherosclerosis, which may eventually lead to cardiovascular events. Non-high-density lipoprotein cholesterol (non-HDL-C) levels are quantified to assess residual risk in statin-treated patients with coronary heart disease. The study aimed to estimate the predictive performance of discordance between non-HDL-C and LDL-C on clinical prognosis in statin-treated patients with previous coronary artery bypass grafting (CABG). Methods: 468 statin-treated patients with previous CABG undergoing percutaneous coronary intervention (PCI) as a secondary coronary treatment due to acute coronary syndrome (ACS) were retrospectively enrolled in this study. The definition of major adverse cardiovascular events (MACEs) was a composite endpoint of cardiovascular death, recurring myocardial infarction, and a need for repeat revascularization. Cox proportional hazards modeling, restricted cubic splines regression, and discordance analysis were conducted to the association between all lipid parameters and the occurrence of MACEs. Discordant values were defined as LDL-C concentrations ≤1.8 mmol/L accompanied by non-HDL-C >2.6 mmol/L. Results: MACEs occurred in 95 patients over a median follow-up period of 744.5 days. Cox models demonstrated that increased concentrations of non-HDL-C and LDL-C levels were independent risk indicators of MACEs (p < 0.001). The restricted cubic spline analysis revealed a linear relationship between non-HDL-C concentrations and MACEs (p-nonlinear: 0.26), whereas a nonlinear relationship was observed between LDL-C concentrations and MACEs (p < 0.01). In the subgroup analysis, the spline curves revealed that the odds of the individuals with desirable LDL-C levels suffering MACEs emerged when non-HDL-C levels were above 2.07 mmol/L. Individuals who exhibited discordance involving high non-HDL-C/low LDL-C levels had an elevated risk of experiencing MACEs compared to those with concordantly low LDL-C and low non-HDL-C levels [hazard ratios (HRs) = 2.44, 95% confidence interval (CI) = 1.14–5.22, p = 0.02]. Conclusions: Non-HDL-C levels could predict the residual risk of MACEs in ACS patients with previous CABG and statin therapy that underwent percutaneous coronary intervention. A discordance between non-HDL-C and LDL-C in individuals with desirable LDL-C levels could be useful in identifying those with a residual risk of cardiovascular complications.https://www.imrpress.com/journal/RCM/24/9/10.31083/j.rcm2409263discordancenon-hdl-cprior coronary artery bypass graftingstatin therapymajor adverse cardiovascular events |
| spellingShingle | Chuang Li Kuizheng He Yixing Yang Kuibao Li Mulei Chen Lefeng Wang Yuanfeng Gao Xiaorong Xu Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary Intervention Reviews in Cardiovascular Medicine discordance non-hdl-c prior coronary artery bypass grafting statin therapy major adverse cardiovascular events |
| title | Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary Intervention |
| title_full | Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary Intervention |
| title_fullStr | Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary Intervention |
| title_full_unstemmed | Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary Intervention |
| title_short | Discordance of Circulating Non-HDL Cholesterol with LDL Cholesterol Concerning Long-Term Prognosis in Statin-Treated Individuals with Acute Coronary Syndrome and Previous Coronary Artery Bypass Grafting Undergoing Percutaneous Coronary Intervention |
| title_sort | discordance of circulating non hdl cholesterol with ldl cholesterol concerning long term prognosis in statin treated individuals with acute coronary syndrome and previous coronary artery bypass grafting undergoing percutaneous coronary intervention |
| topic | discordance non-hdl-c prior coronary artery bypass grafting statin therapy major adverse cardiovascular events |
| url | https://www.imrpress.com/journal/RCM/24/9/10.31083/j.rcm2409263 |
| work_keys_str_mv | AT chuangli discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention AT kuizhenghe discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention AT yixingyang discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention AT kuibaoli discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention AT muleichen discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention AT lefengwang discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention AT yuanfenggao discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention AT xiaorongxu discordanceofcirculatingnonhdlcholesterolwithldlcholesterolconcerninglongtermprognosisinstatintreatedindividualswithacutecoronarysyndromeandpreviouscoronaryarterybypassgraftingundergoingpercutaneouscoronaryintervention |