Relationship between blood lipid management and prognosis in patients with different risk stratifications of acute coronary syndrome after percutaneous coronary intervention

Liu Hua; Nie Kehong; Lyu Gang; Chai Junbing; Ma Haifeng

doi:10.3969/j.issn.1674-4055.2025.05.20

Abstract：Objective To study the relationship between blood lipid management and prognosis in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods ACS patients(n=122)underwent PCI were chosen from People's Hospital of Ningguo City from Jan.2021 to Feb.2022,and blood lipid level were compared in ACS patients with different risk stratifications before and after treatment.According to occurrence of major adverse cardiovascular events(MACE)within 2 y after PCI,the patients were divided into MACE group(n=24)and non-MACE group(n=98).The correlation between level of low-density lipoprotein-cholesterol(LDL-C)and prognosis was analyzed in ACS patients,and predictive efficacy of LDL-C for prognosis was analyzed after drawing ROC curve.Results There was significant difference in LDL-C level in ACS patients with different risk stratifications,and LDL-C level was significantly higher in high-risk group than that in low-risk group(P＜0.05).After treatment,the levels of total cholesterol(TC),high-density lipoprotein-cholesterol(HDL-C)and LDL-C decreased significantly in high-risk group,middle-risk group and low-risk group,and were significantly higher in high-risk group than those in low-risk group(P＜0.05).After adjusting confound factors,the risk of MACE was 1.775 times higher in low-LDL-C group(1.8～3.4 mmol/L),2.203 times higher in middle-LDL-C group(3.4～4.1 mmol/L)and 3.194 times higher in high-LDL-C group(＞4.1 mmol/L)compared with control group(LDL-C＜1.8 mmol/L,P＜0.05).The association intensity showed a nonlinear dose-response relationship between LDL-C level and prognosis in different risk stratification groups(P＜0.001).In predicting MACE occurrence with LDL-C level,the results of ROC curve analysis showed that AUC(0.758),accuracy(0.744)and Jorden index(0.487)were higher in high-risk group than those in middle-risk and low-risk groups.The results of Kaplan-Meier survival curve analysis showed that MACE incidence was higher in group achieved lipid management goals than that in group with suboptimal lipid management(P＜0.05).Conclusion The probability of MACE is higher in ACS patients with substandard lipid management after PCI.The association intensity between LDL-C level and prognosis shows a nonlinear dose-response relationship in ACS patient with stratifications.The efficacy of LDL-C in predicting ACS is higher in patient with high ACS risk than that in patients with middle-low ACS risk.