Application value of sd-LDL/LDL and homocysteine in multivessel coronary artery lesions

Li Jinchao; Chen Min

doi:10.3969/j.issn.1674-7151.2025.02.001

Abstract：Objective To explore the application value of small and dense low-density lipoprotein(sd-LDL)/low-density lipoprotein(LDL)and homocysteine(HCY)in multivessel coronary artery lesions.Methods The 250 patients admitted in Jinan Integrated Traditional Chinese and Western Medicine Hospital who underwent coronary angiography from January 2022 to October 2023 were selected as study objects.According to the degree of coronary artery stenosis,they were divided into study group(150 cases;stenosis degree≥50%)and control group(100 cases;stenosis degree<50%).The level of LDL was measured using direct surfactant elimination method,the level of sd-LDL was detected using peroxidase method,and the level of HCY was detected using enzyme cycle method.The levels of sd-LDL,LDL,sd-LDL/LDL and HCY were compared between the two groups.The receiver operator characteristic curve(ROC curve)was plotted,and the area under ROC curve(AUC)was calculated to evaluate the predictive value of the above indices for coronary stenosis≥50%.The patients in study group were further stratified into single-vessel group(68 cases)and multivessel group(82 cases)according to the number of coronary artery lesions.Lesion severity was assessed using Gensini score,and the patients in study group were divided into low-risk group(56 cases),intermediate-risk group(51 cases)and high-risk group(43 cases).The levels of sd-LDL,LDL,sd-LDL/LDL and HCY were compared across subgroups.Spearman correlation analysis was used to explore associations between the indices and number of coronary lesions or lesion severity.Results The levels of sd-LDL,LDL,sd-LDL/LDL and HCY in study group were significantly higher than those in control group[sd-LDL(mmol/L):1.36±0.47 vs.0.79±0.22;LDL(mmol/L):3.57±0.91 vs.2.76±0.80;sd-LDL/LDL:0.38±0.07 vs.0.29±0.05;HCY(μmol/L):14.58±8.54 vs.12.13±5.39;all P<0.05].The ROC curve analysis showed that the AUCs of LDL,sd-LDL/LDL and HCY for predicting coronary artery stenosis were 0.752,0.867 and 0.600,respectively.The AUC of combined detection was 0.911,which was higher than that of individual detection for each indicator.The levels of sd-LDL,LDL and sd-LDL/LDL in multivessel group were significantly higher than those in single-vessel group[sd-LDL(mmol/L):1.58±0.45 vs.1.09±0.33;LDL(mmol/L):3.89±0.86 vs.3.18±0.83;sd-LDL/LDL:0.41±0.08 vs.0.34±0.05;all P<0.05].There was no significant difference in HCY levels between the two groups.The levels of sd-LDL,LDL and sd-LDL/LDL in high-risk and intermediate-risk coronary lesion groups were significantly higher than those in low-risk group[sd-LDL(mmol/L):1.72±0.47,1.36±0.38 vs.1.06±0.31;LDL(mmol/L):3.96±0.92,3.64±0.83 vs.3.20±0.85;sd-LDL/LDL:0.44±0.08,0.38±0.06 vs.0.33±0.04;all P<0.05].The high-risk group exhibited significantly higher sd-LDL and sd-LDL/LDL levels than intermediate-risk group(both P<0.05),while there was no significant difference in LDL levels between intermediate-risk and high-risk groups.There was no significant difference in HCY levels among the three groups.Spearman correlation coefficient showed that sd-LDL,LDL and sd-LDL/LDL were positively correlated with the number of lesion branches and degree of lesions(r values were 0.534,0.395,0.442,0.595,0.367,0.606;all P<0.001).There was no correlation between HCY and number or degree of coronary lesions(r values were-0.066 and 0.027,P values were 0.425 and 0.738).Conclusions LDL,sd-LDL/LDL and HCY have the predictive value for the degree of coronary artery stenosis,and there are differences among patients with different numbers of coronary lesions and degrees of coronary lesions.LDL and sd-LDL/LDL are positively correlated with the number and degree of coronary lesions,but there is no obvious correlation with HCY.