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
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
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.
关键词
经皮冠状动脉介入治疗/残粒脂蛋白胆固醇/冠状动脉粥样硬化性心脏病/非靶病变进展
Key words
Percutaneous coronary intervention/Remnant lipoprotein-cholesterol/Coronary heart disease/Progression of nontarget lesions
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