The relationship between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol and the prognosis of patients with non ST segment elevation acute coronary syndrome compli-cated with chronic kidney disease
Xie Jiahong
Xian Zhong
Zhu Yurui
Zhou Zekai
Jiang Hongfeng
Abstract：Objective To investigate the relationship between the ratio of non-high-density lipoprotein cholesterol(non-HDL-C)to high density lipoprotein cholesterol(HDL-C)and the prognosis of patients with non ST segment elevation acute coronary syndrome(NSTE-ACS)and chronic kidney disease(CKD)after coronary stent implantation.Methods This study retrospectively enrolled 565 NSTE-ACS patients with CKD who under-went successful coronary stent implantation in Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2020.They were divided into four groups based on non-HDL-C/HDL-C quartiles:group 1(non-HDL-C/HDL-C ≤2.32,n=141),group 2(2.32＜non-HDL-C/HDL-C ≤2.96,n=142),group 3(2.96＜non-HDL-C/HDL-C ≤3.78,n=141),group 4(non-HDL-C/HDL-C＞3.78,n=141).The patients were followed up for 3 years.The primary endpoint was major adverse cardiovascular events(MACE),including all-cause death,nonfatal myocardial infarction,and revascularization.Cox proportional hazards regression model,Kaplan-Meier curve,receiver operating characteristic curve,local weighted regression scatter smoothing method(Lowess)curve were used for statistical analysis.Results Cox proportional hazards regression model analysis showed that the risks of MACE[hazard ratio(HR)=2.06,95％confidence interval(CI):1.28-3.29,P=0.001],all-cause death(HR=2.09,95％CI:1.03-4.22,P=0.004),and repeat revascularization in group 4 were significantly higher than those in group 1.The Kaplan-Meier curve showed that the risk of MACE,all-cause mortality and repeat revascularization increased significantly with the increase of non-HDL-C/HDL-C quartiles(all Log-rank P＜0.05).The predictive ability of the non-HDL-C/HDL-C[the area under the curve(AUC)=0.68]was superior to HDL-C(AUC=0.60)and LDL-C(AUC=0.51).Lowess curve showed that non-HDL-C/HDL-C was positively correlated with MACE.Conclusions Increased levels of non-HDL-C/HDL-C significantly increase the risk of MACE,all-cause death and repeat revascularization in NSTE-ACS patients with CKD after coronary stent implantation,and it was better than HDL-C and LDL-C in predicting the risk of MACE.
Keywords：Non ST segment elevation acute coronary syndromeChronic kidney diseaseNon-high-density lipoprotein cholesterolHigh-density lipoprotein cholesterolStent implantation
Publication Date：2025-03-07
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 321-326 )