Nutr Metab Cardiovasc Dis. 2026 Jul 22:104882. doi: 10.1016/j.numecd.2026.104882. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: To investigate the association between residual cholesterol and inflammatory risk and postoperative outcomes in patients with carotid artery stenosis (CAS) undergoing coronary artery bypass grafting (CABG).
METHODS AND RESULTS: This retrospective study included 1064 patients with CAS undergoing CABG. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C) levels: residual cholesterol and inflammatory risk (RCIR), residual inflammatory risk (RIR), residual cholesterol risk (RCR), and no residual risk (NRR). The primary endpoint was 30-day postoperative major adverse cardiac and cerebrovascular events (MACCEs), defined as a composite of all-cause mortality, myocardial infarction, and stroke. Multivariable logistic regression analyses were performed. After multivariable adjustment, RCIR were significantly related to an increased risk of postoperative MACCEs compared with NRR (adjusted OR, 2.330; 95% CI, 1.232-4.408; P = 0.009), driven primarily by a higher risk of postoperative stroke (adjusted OR, 4.055; 95% CI, 1.224-13.429; P = 0.022). A significant interaction was observed between RCIR and bilateral carotid artery stenosis (P for interaction = 0.015), with RCIR group conferring a markedly increased risk of MACCEs compared with the NRR group among patients with bilateral stenosis.
CONCLUSIONS: Residual cholesterol and inflammatory risk were independently associated with adverse postoperative outcomes in patients with CAS undergoing CABG, primarily driven by postoperative stroke. A potentially stronger association among patients with bilateral carotid artery stenosis was observed, but this finding should be interpreted as exploratory and requires further validation.
PMID:42603765 | DOI:10.1016/j.numecd.2026.104882