Correlation and predictive efficacy analysis of residual lipoprotein-cholesterol and the severity of coronary artery stenosis

Tao Shiyi; Tang Xianwen; Yu Lintong; Yang Deshuang; Zhang Lanxin; Zhang Jin; Huang Li; Wu Jiayun

doi:10.3969/j.issn.1674-4055.2024.03.03

Abstract：Objective To investigate the association between residual lipoprotein-cholesterol(RLP-C)and the severity of coronary artery stenosis and its predictive efficacy.Methods A total of 602 eligible patients with suspected CHD were included from September 2019 to November 2021 in the Department of Integrative Cardiology at China-Japan Friendship Hospital.According to the results of coronary angiography,490 patients were divided into the CHD group,and 112 patients were divided into the CHD group.Basic clinical features and relevant indicators were collected,and RLP-C was calculated according to the formula.The baseline characteristics of the CHD and the nCHD group were compared,and the difference of RLP-C level in the CHD group with different severity of coronary artery stenosis was explored.Multivariate logistic regression analysis was used to explore the influence factors of CHD,and Pearson correlation analysis was used to analyze the association between RLP-C and the severity of coronary artery stenosis.The predictive efficacy of RLP-C on moderate to severe coronary artery stenosis was synthetically evaluated by the area under the curve(AUC)of the receiver operating characteristic(ROC)and decision curve analysis(DCA).Results Multivariate logistic regression analysis showed that men were a protective factor against coronary artery stenosis.However,age,smoking history,diabetes history,high total cholesterol(TC)level,high homocysteine(HCY)level,high hemoglobin A1c(HbA1c)level,high brachial-ankle pulse wave velocity(baPWV)level,high RLP-C level and high Gensini score level were risk factors.There were no significant differences between the low and moderate stenosis groups.Except for the sex index,the remaining indicators were statistically significant between the low and severe stenosis and moderate and severe stenosis groups,respectively.The difference in smoking history was statistically significant only between the low and severe stenosis groups.Pearson correlation analysis showed that RLP-C was positively correlated with Gensini score(r=0.526,P＜0.05).The AUC for RLP-C was 0.525(0.407,0.643),and the combined AUC was 0.705(0.610,0.800);when the threshold probability was＞40%,the combined prediction of moderate to severe coronary stenosis was more favorable to predict the moderate to severe coronary artery stenosis than to made treatments for all patients.Conclusion RLP-C is an important risk factor for CHD,which is positively correlated with the severity of coronary artery stenosis.RLP-C has an advantage in predicting moderate to severe coronary artery stenosis and has better clinical power when combined with other factors.