Abstract
ObjectiveThe present study investigated the potential correlation between non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (non-HDL-C/HDL) and the formation of coronary collateral circulation (CCC) in coronary artery disease cases with chronic total occlusive (CTO) lesions.MethodsTwo experienced cardiologists identified and selected patients with CTO lesions for retrospective analysis. The 353 patients were divided into a CCC poor formation group (Rentrop 0–1 grade, n = 209) and a CCC good formation group (Rentrop 2–3 grade, n = 144) based on the Cohen-Rentrop standard. A comparison of non-HDL-C/HDL ratios between the two groups was performed. The Spearman test was used to obtain the correlation between the cholesterol ratio and Rentrop grade. Independent predictors of CCC were analyzed using logistic regression. Receiver operating characteristic (ROC) curve analysis was also performed to quantify the predictive value of research indicator.ResultsThe non-HDL-C/HDL ratio in the CCC poor formation group was elevated markedly compared to the CCC good formation group [( 3.86 ± 1.40) vs ( 3.31 ± 1.22), P = 0.000]. The Spearman test results indicated that non-HDL-C/HDL negatively correlated with Rentrop grade (r = − 0.115, P = 0.030). Multivariate logistic regression analysis showed that non-HDL-C/HDL ratio was an independent predictor of CCC formation (OR = 1.195, 95%CI = 1.020–1.400, P = 0.027). The area under the curve of ROC for detecting CCC poor formation was 0.611 (95% CI: 0.551–0.671, P = 0.000) with an optimal cut-off value of 2.77.ConclusionNon-HDL-C/HDL negatively correlated with the formation of CCC and served as an independent predictor of CCC formation, which may be used as a biomarker for the evaluation of CCC.
Highlights
Chronic total occlusions (CTOs) are an important subtype of coronary artery disease (CAD) and pose a great threat to a patient’s prognosis because it remainsLi et al BMC Cardiovasc Disord (2021) 21:311 reduced myocardial infarcts and improved the prognosis of patients [6, 7]
Clinical physicians examined the non-high-density lipoprotein cholesterol (HDL-C)/HDL, this index represents the ratio of cholesterol contained in all of the atherosclerosis-promoting particles and cholesterol contained in all the anti-atherosclerosis particles (HDLC) in the serum, to evaluate lipid-related diseases
Study strengths and limitations The present study demonstrated that in CTO patients 1) the non-HDL-C/HDL ratio in the collateral circulation (CCC) poor formation group was significantly elevated compared to the CCC good formation group and 2) the non-HDL-C/HDL ratio negatively correlated with the formation of CCC and may be developed as an independent predictor of CCC formation
Summary
Chronic total occlusions (CTOs) are an important subtype of coronary artery disease (CAD) and pose a great threat to a patient’s prognosis because it remainsLi et al BMC Cardiovasc Disord (2021) 21:311 reduced myocardial infarcts and improved the prognosis of patients [6, 7]. The existing evaluation methods (e.g., Collateral Flow Index (CFI), contrast echocardiography, and myocardial perfusion imaging) for the formation of CCC in patients with CTO are relatively complicated and expensive. Clinical physicians examined the non-HDL-C/HDL, this index represents the ratio of cholesterol contained in all of the atherosclerosis-promoting particles (non-HDL-C) and cholesterol contained in all the anti-atherosclerosis particles (HDLC) in the serum, to evaluate lipid-related diseases. Some findings indicated that this cholesterol ratio was a better index than apolipoprotein B/apolipoprotein A1 and conventional single lipid parameter for identifying lipidrelated diseases, such as insulin resistance, metabolic syndrome and CAD [8, 9]. Few studies focused on the role of non-HDL-C/HDL ratio for predicting CCC formation in patients with CTO. The present study estimated the association between the non-HDL-C/HDL ratio and the formation of CCC
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