Effect of Residual Cholesterol on Long-Term Prognosis in Patients with Acute Coronary Syndrome with or without Diabetes Mellitus
Objective To investigate the impact of residual cholesterol on the long-term prognosis of patients with acute coronary syndrome(ACS).Methods ACS patients treated at 11 hospitals in Chengdu from January 2017 to June 2019 were included in the study.Patients were divided into non-diabetic group and diabetic group based on whether they had diabetes mellitus.Subquently they were devided into residual cholesterol＜0.8 mmol/L and residual cholesterol≥0.8 mmol/L subgroups based on residual cholesterol levels(threshold 0.8 mmol/L).The study endpoints were major adverse cardiovascular and cerebrovascular events(MACCE),including all-cause death,non-fatal myocardial infarction,non-fatal stroke,and revascularization.The incidence of MACCE in the residual cholesterol＜0.8 mmol/L group and residual cholesterol≥0.8 mmol/L group were compared.Results Our study included 1 568 ACS patients,of whom 1 162 patients were non-diabetic patients.Among them,954 patients were in the residual cholesterol＜0.8 mmol/L group,and 208 patients were in the residual cholesterol≥0.8 mmol/L group.There were 406 diabetic patients,with 311 patients in the residual cholesterol＜0.8 mmol/L group and 95 patients in the residual cholesterol≥0.8 mmol/L group.The median follow-up time was 14 months(8,21 months).In non-diabetic patients,residual cholesterol≥0.8 mmol/L was an independent predictor of MACCE in ACS patients(HR=1.786,95％CI 1.031～3.094,P=0.039).However,in diabetic patients,residual cholesterol≥0.8 mmol/L was not an independent predictor of MACCE in ACS patients(HR=0.962,95％CI 0.486～1.904,P=0.912).Conclusion High level residual cholesterol is an independent predictor of long-term poor prognosis in ACS patients without diabetes mellitus,but not in ACS patients with diabetes mellitus.
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