Predictive efficacy of combined detection of serum residual cholesterol/high-density lipoprotein cholesterol ratio and blood uric acid for the risk of recent acute adverse cardiovascular events in patients with borderline coronary heart disease

LIU Long; YANG Ling; MAO Shao-Bin; YANG Zhuo-Xuan

doi:10.3969/j.issn.1672-5301.2025.10.007

Abstract：Objective To evaluate the predictive efficacy of jointly measuring the residual cholesterol/high-density lipoprotein cholesterol ratio(RC/HDL-C)and serum uric acid(UA)for the risk of recent acute adverse cardiovascular events in patients with borderline coronary heart disease.Methods A total of 203 patients with borderline coronary artery disease admitted to Yuncheng Central Hospital from September 2022 to October 2024 were selected as the training set.The patients were divided into the concurrent group and the non-concurrent group based on the recent occurrence of acute adverse cardiovascular events.Propensity score matching(PSM)was used to match the two groups in a 1∶1 ratio.The other 30 patients were selected as the external validation set.The levels of the serum RC/HDL-C and UA were compared between the two groups.Logistic regression analysis was conducted to identify the risk factors for the recent occurrence of acute adverse cardiovascular events in patients with borderline coronary artery disease.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of the serum RC/HDL-C,UA,and their combined use for predicting the risk of acute adverse cardiovascular events.In the external validation set,the consistency between the combined prediction results and clinical reality was analyzed using the Kappa value.An economic analysis was also conducted on the RC/HDL-C,UA and their combined prediction.Results The concurrent group had significantly higher serum RC/HDL-C and UA levels than the non-concurrent group,the differences were statistically significant(P<0.05).Logistic regression analysis indicated that the levels of the serum RC/HDL-C and UA were associated factors for the recent occurrence of acute adverse cardiovascular events in the patients with borderline coronary artery disease(P<0.05).The ROC curve analysis revealed that the AUC values of the serum RC/HDL-C,UA and their combined prediction for the risk of acute adverse cardiovascular events were 0.733,0.741 and 0.909,respectively(P<0.05);the combined AUC value was significantly higher than that of the serum RC/HDL-C and UA alone(Z=2.720,2.589;P=0.007,0.009).The Kappa value consistency analysis showed that the combined prediction results had a concordance rate of 90.00%with clinical reality,with a Kappa value of 0.706(P<0.05).Economic analysis indicated that,using the AUC value as the final outcome measure,the costs per unit AUC for the serum RC/HDL-C,UA and their combined detection were 13.64 yuan,26.99 yuan and 33.00 yuan,respectively.The cost per unit AUC for the combined detection was 19.36 yuan and 6.01 yuan higher than that for the UA and RC/HDL-C alone respectively,which was within an acceptable range.Furthermore,combining the two tests improved the predictive performance by 17.60%(AUC increased from 0.733 to 0.909)and 16.80%(AUC increased from 0.741 to 0.909).Conclusions The combined detection of the serum RC/HDL-C and UA can enhance the predictive value of the risk of recent acute adverse cardiovascular events in the patients with borderline coronary artery disease,providing a reference for precise stratification and intervention timing selection for these patients.