Association between nontraditional lipid parameters and cardiovascular outcomes in patients undergoing percutaneous coronary intervention: a retrospective study

Abstract

Background Nontraditional lipid parameters, such as the atherogenic index of plasma (AIP), triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL ratio), Castelli Risk Index I (CRI-I), Castelli Risk Index II (CRI-II), fasting blood glucose to high-density lipoprotein cholesterol ratio (GHR), and lipoprotein combine index (LCI), have been implicated in cardiovascular disease. This study aims to explore the correlation between nontraditional lipid parameters and cardiovascular outcomes in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), while also evaluating their predictive capabilities. Methods The study included 2533 consecutive patients who underwent PCI. Data from 2006 patients were analyzed using multivariate logistic models to analyze the association between nontraditional lipid parameters and major adverse cardiac and cerebrovascular events (MACCEs). Results Over a 34-month follow-up, 338 patients (16.8%) experienced MACCEs. The multivariate logistic regression analysis revealed a significant association, showing that a 1.0-SD increment in CRI-I (OR: 1.15, 95% CI: 1.03–1.30), CRI-II (OR: 1.20, 95% CI: 1.07–1.35), and LCI (OR: 1.19, 95% CI: 1.06–1.34) was significantly related to MACCEs in the overall population (all P < 0.01). Subgroup analyses revealed significant interactions between AIP, TG/HDL ratio, and GHR with sex subgroups. In female patients, after adjusting for other risk factors, AIP (OR: 1.26, 95% CI: 1.00-1.60), TG/HDL ratio (OR: 1.34, 95% CI: 1.03–1.74), and GHR (OR: 1.25, 95% CI: 1.00-1.56) were significantly associated with MACCEs (all P < 0.05). Multivariable-adjusted RCS curves illustrated a linear correlation between CRI-I, CRI-II, and LCI with MACCEs, and a nonlinear relationship between GHR and MACCEs in overall population. When CRI-II is added to the model with fully adjusting variables, its predictive performance may be enhanced (NRI = 0.158, P = 0.009; IDI = 0.005, P = 0.017). Conclusion There was a significant correlation between nontraditional lipid parameters and the risk of MACCEs in patients undergoing PCI. The CRI-II has the potential to enhance the predictive performance of traditional risk models and emerges as the most valuable among nontraditional lipid parameters.