Higher serum triglyceride can predict recurrent coronary revascularization events in patients undergoing percutaneous coronary intervention with baseline LDL-C <55 mg/dL. (January 2023)

• Record Type: Journal Article
• Authors: Fan, Xiaojuan; Wang, Xiaoke; She, Jianqing; Niu, Xiaoqian; Luo, Yongbai; Xi, Wen; Zheng, Tao; Wu, Yue
• Is Part Of: Journal of investigative medicine. Volume 71:Number 1(2023)
• Page Start: 47
• Page End: 52
• Publication Date: 2023-01
• Subjects: triglycerides -- cholesterol -- coronary artery disease -- percutaneous coronary intervention; Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.1136/jim-2022-002401
• Languages: English
• ISSNs: 1081-5589

Abstract

Patients with low baseline low-density lipoprotein cholesterol (LDL-C) but experiencing recurrent coronary revascularization events have been rarely investigated. In this retrospective cohort study, we enrolled patients undergoing percutaneous coronary intervention (PCI) with baseline LDL-C &lt;55 mg/dL at the First Affiliated Hospital of Xi&#39;an Jiaotong University between January and December 2017. Subsequent ischemia-driven coronary revascularization events and all-cause death were documented during a 4-year follow-up. Cox analysis was used to evaluate the association between baseline clinical characteristics and long-term events. As a result, among 388 patients (mean age 63 years; 79.1% male) enrolled, 32 patients underwent recurrent revascularization events, and 38 patients occurred all-cause death. After adjustment for age, diabetes mellitus, multi-vessel disease, and lipoprotein(a), multivariate Cox analysis showed that baseline serum triglyceride (TG) (HR 1.691, 95% CI 1.178 to 2.428, p=0.004) was an independent predictor of recurrent coronary revascularization events. Kaplan-Meier analysis revealed that a higher TG level (≥1.17 mmol/L, determined by receiver operating characteristic curve) was associated with increased risk of recurrent revascularization events than lower TG level (&lt;1.17 mmol/L) (p=0.021). Female (HR 2.647, 95% CI 1.350 to 5.190, p = 0.005) and previous atrial fibrillation (HR 3.163, 95% CI 1.403 to 7.132, p=0.006) were associated with increased risk of all-cause death. In conclusion, for patients undergoing PCI with baseline LDL-C &lt;55 mg/dL, higher baseline TG can predict recurrent coronary revascularization events.