Abstract 16738: Impact of Remnant Cholesterol Level on Long-Term Outcomes in Patients With Multivessel Disease Undergoing Coronary Artery Bypass Grafting

Abstract

Introduction: The remnant cholesterol (RC) is being increasingly documented as an important risk factors of coronary artery disease. Thus far, the impact of RC level on the long-term outcomes of patients with multivessel coronary artery disease (MVD) undergoing coronary artery bypass graft (CABG) has not been investigated. Hypothesis: Elevated RC level is associated with increased risk of MACCEs in patients with MVD undergoing CABG. Methods: All patients who were diagnosed with multivessel coronary artery disease and undergoing CABG between 2011 and 2020 were considered for enrollment. RC was calculated as total cholesterol minus HDL-C minus LDL-C. Patients were categorized by RC thresholds and the occurrence of major adverse cardiovascular and cerebrovascular events (MACCEs) was examined according to the RC level at one-year post-CABG. Results: A total of 2,072 patients (60.8 ± 8.3 years; 83.5% men) were included in this study. Patients was divided into four groups: RC < 0.5 mmol /L, RC of 0.5-0.99 mmol/L, RC of 1.0-1.49, mmol/L, and RC ≥ 1.5 mmol/L. During a median follow-up of 4.2 years after the 1-year assessment, 25.0% of the patients had occurrences of MACCEs. The multivariable adjusted hazard ratios (95% CI) for MACCEs, cardiac death, nonfatal myocardial infarction, re-revascularization, cardiac rehospitalization (admission because of angina or heart failure) and nonfatal stroke, were respectively 2.49 (1.99-3.12), 2.20 (1.18-3.86), 3.18 (2.16-5.84), 3.02 (2.12-4.34), 1.93 (1.42-2.87), and 1.37 (0.83-2.27) in patients with RC ≥ 1.50 mmol/L, compared with patients with 1-year RC < 0.5 mmol/L. The 1-year RC level was significantly associated with MACCEs, with the lowest risk of MACCEs reflected in the patients with RC < 0.5 mmol/L. Conclusions : In patients with MVD undergoing CABG, the RC level at one-year after CABG were independently associated with long-term outcomes.