Correlation between remnant lipoprotein-cholesterol at different blood fat levels and progression of nontarget lesions in patients with coronary heart disease after percutaneous coronary intervention

Lu Xiangyu; Teng Tianqi; Liu Jing

doi:10.3969/j.issn.1674-4055.2024.06.20

Abstract：Objective To analyze and discuss the correlation between remnant lipoprotein-cholesterol(RLP-C)at different blood fat levels and progression of nontarget lesions in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods CHD patients undergone PCI(n=769)were chosen from Department of Cardiology in the First People's Hospital of Lianyungang City from May 2020 to May 2023,and all patients were given reexamination of coronary arteriography(CAG)within 6 months to 24 months after the operation.The patients were divided,according to level of low-density lipoprotein cholesterol(LDL-C)into compliance group and non-compliance group,and patients were also divided,according to vascular lesion progression analyzed with quantitative coronary angiography(QCA),into nontarget lesion group and non-nontarget lesion group.The clinical features of progression of nontarget lesions at different blood fat levels were compared,and independent risk factors for progression of nontarget lesions were analyzed,and significance of RLP-C in progression of nontarget lesions was studied.Results The compliance rate of LDL-C controlling was lower(37.84％)in CHD patients after PCI,but risk of progression of nontarget lesions increased significantly.When LDL-C controlling was poor,smoking,multi-vessel lesions and LDL-C were independent risk factors for progression of nontarget lesions.When LDL-C controlling was good,RLP-C,diabetes,smoking and multi-vessel lesions were independent risk factors for progression of nontarget lesions.The higher RLP-C would induce progression of nontarget lesions as a residual lipid risk.The best predictive value of RLP-C was 0.555 mmol/L,sensitivity was 81.4％and specificity was 63.7％.The percentages of CHD patients complicated by diabetes and revascularization with higher RLP-C level were significantly higher than those in patients with lower RLP-C level(x2=5.072,P=0.024).Conclusion In clinical practice,it is necessary to strengthen the intensive treatment of LDL-C in patients.RLP-C has certain advantages in predicting progression of nontarget lesions in patients with good lipid controlling after PCI.The monitoring and controlling of RLP-C should be strengthened in diabetic patients during follow-up period to delay progression of nontarget lesions and reduce revascularization risk.