Relationship Between Preoperative Low-Density Lipoprotein Cholesterol and Periprocedural Myocardial Injury in Patients Following Elective Percutaneous Coronary Intervention in Southern China

Zhong, Zhixiong; Liu, Jing; Zhang, Zuo‐Feng; Zhong, Wei; Li, Bin; Li, Cunren; Liu, Zhidong; Yang, Min; Zhao, Pingsen

doi:10.12659/msm.907400

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…We also observed that the treatment for risk factors in the young CHD patients before admission were also low, with only 16.9%, 8.1%, 13.7%, and 10.9% of patients treated with anti-hypertensive, antidiabetic, anti-platelet medications, and statins, respectively. These data strongly support the notion that risk factor treatment is essential to prevent CHD [24]. Interestingly and importantly, we found that the reason most of young CHD patients underwent coronary artery stenting was not due to myocardial infarction.…”

Section: Discussionsupporting

confidence: 88%

Clinical Characteristics and Prognosis of Young Patients with Coronary Heart Disease

et al. 2020

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Departmental sources Background: The objective of this study was to investigate the clinical characteristics and prognosis of coronary heart disease (CHD) in young patients. Material/Methods: We included 972 CHD patients (£50 years old) with coronary artery stenting who were prospectively enrolled and followed for 1 year. Clinical characteristics, risk factors, and predictors of outcomes were evaluated. Results: The prevalence of current smoker, hypertension, diabetes mellitus, dyslipidemia and positive family history of CHD were 18.9%, 34.3%, 14.5%, 4.4%, and 44.2%, respectively. Most of the patients underwent coronary stenting due to stable angina (48.8%) and unstable angina (UA; 48.1%). After 1-year follow-up, 64 patients (6.6%) experienced clinical outcomes and the most common event was UA (n=56). Compared to patients without clinical outcomes, those with outcomes were more likely to be male, have higher systolic blood pressure, more likely to have hypertension and diabetes mellitus, and more likely to be presented as unstable angina. Multivariate regression analysis showed only age (hazard ratio [HR]: 1.12 and 95% confidence interval [

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Section: Discussionsupporting

confidence: 88%

Clinical Characteristics and Prognosis of Young Patients with Coronary Heart Disease

et al. 2020

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“…Numerous evidences have revealed that LDL-C serum concentrations correlate with very high cardiovascular risk and stringent LDL-C lowering with statins therapy is recommended for the secondary prevention of recurrent cardiovascular events and survival improvement after PCI by the current international guidelines [16, 17]. Another research of ours found that PCI patients with lower preprocedural LDL-C were less risky to periprocedural myocardial injury in southern China [18]. Data from patients treated with statins show considerable gains by approximately 22% per 1.0 mmol/L LDL-C reduction [19].…”

Section: Introductionmentioning

confidence: 91%

Assessment of the LDL-C/HDL-C ratio as a predictor of one year clinical outcomes in patients with acute coronary syndromes after percutaneous coronary intervention and drug-eluting stent implantation

et al. 2019

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BackgroundDespite significant advances in the management of acute coronary syndromes (ACS), there are still plenty of patients undergoing percutaneous coronary intervention (PCI) and stent implantation suffered poor prognosis and high treatment expenditure. Evidence increasingly suggests that the ratio of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio might be a novel marker for the risk of atherosclerotic cardiovascular disease, but the impact of LDL-C/HDL-C ratio on 1-year prognosis of drug-eluting stent (DES) implantation patients after PCI is still not reported. Our aim of the study was to investigate the impact of LDL-C/HDL-C ratio on 1-year prognosis of DES implantation patients after PCI.MethodsBetween May 2014 and July 2016, 1937 patients who were underwent primary PCI and DES implantation and achieving LDL-C with statins were enrolled and divided into two groups based on the ratio of LDL-C/HDL-C.ResultsThe entire occurrence of adverse cardiovascular events according to the ratio of LDL-C/HDL-C showed that there were no significant differences in 1-year cardiovascular death (hazard ratio [HR]: 1.97, 95% confidence interval [CI]: 0.49 to 7.84, P = 0.329), myocardial infarction (MI) (HR: 1.66, 95% CI: 0.84 to 3.28, P = 0.172) and bleeding events (HR: 1.08, 95% CI: 0.83 to 1.41, P = 0.598) The cumulative incidence of target lesion revascularization (TLR) (HR: 1.43, 95% CI: 1.10 to 1.86, P = 0.007), stent thrombosis (ST) (HR: 2.04, 95% CI: 1.06 to 3.93, P = 0.037) and major adverse cardiac events (MACE) (HR: 1.54, 95% CI: 1.24 to 1.91, P < 0.001) were significantly higher in high group than in low group. Multivariate Cox regression analysis revealed that age (HR: 1.556, 95%, CI: 1.198 to 2.021, P < 0.001), together with diabetes mellitus (HR: 1.490, 95% CI: 1.142 to 1.945, P = 0.003), and ratio of LDL-C/HDL-C (HR: 1.638, 95% CI: 1.260 to 2.218, P < 0.001) were independent predictors of 1-year MACE. The Kaplan-Meier cumulative MACE-free survival curves with a log-rank test showed that the presence of high ratio of LDL-C/HDL-C was associated with higher incidences of MACE after PCI with DES implantation.ConclusionsThe high LDL-C/HDL-C ratio was associated with cardiovascular events in patients with ACS after PCI and DES implantation.

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“… 20 , 23 In addition, the independent predictive value of total stent length was demonstrated, which also provided evidence with interventional cardiologists when making procedural plans to prevent UA patients from adverse myocardial injury and neurosis. Other studies have found that postoperative LDL-C is associated with perioperative myocardial infarction and long-term prognosis, 11 , 20 , 23 but in this study, the OR value was statistically analyzed after the classification of LDL-C. In addition, the relationship between total stent length and perioperative myocardial infarction was found in this study, which has hardly been reported in other studies.…”

Section: Discussionmentioning

confidence: 78%

“…Patients with UA were characterized as having ischemic symptoms at rest or minimal exertional without myocardial infarction. 20 …”

Section: Methodsmentioning

confidence: 99%

LDL-C and Total Stent Length are Independent Predictors of Periprocedural Myocardial Injury and Infarction for Unstable Angina Patients Undergoing Elective Percutaneous Coronary Intervention

Chen

Rong

et al. 2021

IJGM

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Background To investigate the predictive value of low-density lipoprotein cholesterol (LDL-C), total stent length and number of implanted stents in patients with unstable angina (UA) regarding myocardial injury and infarction during perioperative period. Methods Three hundred and fifteen consecutive UA patients between January 2015 and June 2018 were retrospectively recruited from two cardiac centers of Hebei Province, China. These patients had normal preprocedural cardiac troponin I (cTnI) and underwent uneventful revascularizations. The predictive value of baseline LDL-C level and total stent length was investigated by linking to post procedural cTnI value in this cohort. Meanwhile, other related clinical and procedural variables were analyzed. Results Baseline LDL-C level or LDL-C grade was correlated with post percutaneous coronary intervention (PCI) cTnI levels (r = 0.120, P = 0.01; r = 0.157, P = 0.004). LDL-C grade was an independent risk factor of perioperative myocardial injury and infarction (P < 0.05) after multivariable adjustment. The risk increased with the elevation of baseline LDL-C level. Compared to the lowest level group (<70 mg/dl), the group with 70–99 mg/dl carried three times higher risk (OR = 3.318; 95% CI: 1.167–9.436; P < 0.05). And, patients with LDL-C level ≥100 mg/dl had the worst prognosis (OR = 4.783; 95% CI: 1.736–13.180; P = 0.002). Besides, the study also found that the total length of stent was predictive of perioperative myocardial injury and infarction independently (OR = 1.037; 95% CI: 1.017–1.058; P = 0.001). Conclusion Baseline LDL-C level and total stent length were independent predictors of periprocedural myocardial injury and infarction in UA patients undergoing elective PCI.

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Relationship Between Preoperative Low-Density Lipoprotein Cholesterol and Periprocedural Myocardial Injury in Patients Following Elective Percutaneous Coronary Intervention in Southern China

Cited by 8 publications

References 31 publications

Clinical Characteristics and Prognosis of Young Patients with Coronary Heart Disease

Clinical Characteristics and Prognosis of Young Patients with Coronary Heart Disease

Assessment of the LDL-C/HDL-C ratio as a predictor of one year clinical outcomes in patients with acute coronary syndromes after percutaneous coronary intervention and drug-eluting stent implantation

LDL-C and Total Stent Length are Independent Predictors of Periprocedural Myocardial Injury and Infarction for Unstable Angina Patients Undergoing Elective Percutaneous Coronary Intervention

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