Medicine (Baltimore). 2026 Oct 2;105(40):e50907. doi: 10.1097/MD.0000000000050907.
ABSTRACT
To investigate the predictive value of non-high-density lipoprotein cholesterol (non-HDL-C) and remnant cholesterol (remnant-C) for the progression of non-culprit coronary lesions with quantitative flow ratio ≤ 0.80. A total of 214 patients with coronary artery disease undergoing percutaneous coronary intervention from January 2022 to March 2024 were consecutively enrolled, with 321 non-culprit lesions. All patients completed at least 24 months of clinical follow-up. Based on follow-up quantitative coronary angiography assessment, patients were divided into lesion progression and non-progression groups. Baseline clinical data, laboratory parameters, and coronary angiography characteristics were collected. Univariate and multivariate logistic regression analyses were performed to assess the independent predictive value of non-HDL-C and remnant-C for lesion progression. Predictive performance was compared using receiver operating characteristic curves, and subgroup analyses were conducted. During follow-up, 62 patients (29.0%) experienced non-culprit lesion progression. The median angiographic follow-up interval was 14.2 months (interquartile range, 10.8-18.1; range, 6.1-23.8) overall and did not differ significantly between the progression and non-progression groups (14.6 vs 14.0 months, P = .47). Multivariable logistic regression showed that, after adjustment for prespecified clinical covariates, both non-HDL-C (odds ratio = 1.68, 95% confidence interval: 1.22-2.31, P = .001) and remnant-C (odds ratio = 1.52, 95% confidence interval: 1.24-1.86, P < .001) were independently associated with lesion progression. The apparent areas under the curves were 0.72 for non-HDL-C and 0.70 for remnant-C; after adding clinical variables, the apparent areas under the curves were 0.84 and 0.83, respectively. Numerically larger effect estimates were observed in patients with diabetes mellitus, multivessel disease, and renal dysfunction, but all interaction P values were >.05. Non-HDL-C and remnant-C are independent predictors of progression of non-culprit coronary lesions with quantitative flow ratio ≤ 0.80. Combining them with traditional risk factors significantly improves predictive performance, offering clinical value for high-risk patient identification and secondary prevention optimization.
PMID:42826270 | DOI:10.1097/MD.0000000000050907