Abstract
BackgroundIt is uncertain whether estimated remnant-like particle cholesterol (RLP-C) could predict residual risk in patients with different glycometabolic status. This study aimed to evaluate the relationship between estimated RLP-C and adverse prognosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) treated with percutaneous coronary intervention (PCI) and to identify the potential impact of glycometabolism on the predictive value of estimated RLP-C.MethodsThe study assessed 2419 participants with NSTE-ACS undergoing PCI at Beijing Anzhen Hospital from January to December 2015. Estimated RLP-C was calculated as follows: total cholesterol (TC) minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The adverse events included all-cause death, non-fatal myocardial infarction (MI), and ischemia-driven revascularization.ResultsEstimated RLP-C was prominently associated with adverse prognosis in the total population [hazard ratio (HR) 1.291 per 1-SD increase, 95% confidence interval (CI) 1.119–1.490, P < 0.001], independent of confounding risk factors. However, subgroup analysis showed that increasing estimated RLP-C was related to a higher risk of adverse events in the diabetic population only [HR 1.385 per 1-SD increase, 95% CI 1.183–1.620, P < 0.001]. Estimated RLP-C failed to be a significant determinant of adverse prognosis in non-diabetic and pre-diabetic subgroups. The addition of estimated RLP-C to a baseline model including traditional risk factors enhanced the predictive performance both in total and diabetic populations.ConclusionsHigh estimated RLP-C level is a significant predictor for recurrent adverse events in patients with diabetes and NSTE-ACS treated with PCI.
Highlights
It is uncertain whether estimated remnant-like particle cholesterol (RLP-C) could predict residual risk in patients with different glycometabolic status
The prevalence of prior myocardial infarction (MI), percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), stroke, and diabetes were higher in the group with an event
More participants were diagnosed with non-ST segment elevation myocardial infarction (NSTEMI), and more angiotensin-converting enzyme inhibitors (ACEI), oral hypoglycemic agents, and insulin were prescribed in patients with an adverse event
Summary
It is uncertain whether estimated remnant-like particle cholesterol (RLP-C) could predict residual risk in patients with different glycometabolic status. Low-density lipoprotein cholesterol (LDL-C) has been extensively recognized as the significant risk factor for ASCVD, reduction of which is an effective therapy to reduce cardiovascular risks [3]. Despite regulating LDL-C with guideline-recommended therapies, patients with ACS remain at a higher risk of recurrent cardiovascular outcomes [4,5,6,7], which indicates that there are factors other than LDL-C that determine risk. The pattern of targeting LDL-C alone has changed, with recent guidelines highlighting the importance of non-high-density lipoprotein cholesterol (nonHDL-C), which includes RLP-C, on the pathogenesis of atherosclerosis and its availability as an additional therapeutic target [11]. As a component of non-HDL-C, it is of great significance to further clarify the effect of RLP-C on coronary atherosclerosis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
