Research Article: Prognostic value of combined LDL-C and remnant cholesterol stratification for 24-month major adverse cardiovascular events after primary PCI in patients with STEMI
Abstract:
This single-center prospective observational cohort study aimed to investigate the prognostic value of combined low-density lipoprotein cholesterol (LDL-C) and remnant cholesterol (RC) stratification in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
A total of 812 STEMI patients were enrolled and stratified into four groups according to LDL-C and RC levels measured at 1-month post-PCI. The primary endpoint was 24-month major adverse cardiovascular events (MACE).
The overall MACE rate increased stepwise across the four subgroups ( P <?0.001). Multivariate Cox regression showed that elevated RC was independently associated with MACE (HR?=?1.559, 95% CI: 1.018?2.386, P =?0.041), whereas isolated high LDL-C was not (HR?=?1.329, 95% CI: 0.992?1.781, P =?0.057). Compared with the low LDL-C?+?low RC group, the high LDL-C?+?high RC group carried the highest MACE risk (HR?=?2.535, 95% CI: 1.591–4.041, P <?0.001), followed by the low LDL-C?+?high RC group (HR?=?1.874, 95% CI: 1.153–3.045, P =?0.011).
Combined LDL-C and RC stratification may assist risk evaluation in STEMI patients after primary PCI. Elevated RC, rather than isolated high LDL-C, is associated with adverse outcomes, which may help identify patients with residual lipid-related risk.
Introduction:
Acute ST-segment elevation myocardial infarction (STEMI) remains one of the most life-threatening acute coronary syndromes, characterized by rapid onset, extensive myocardial necrosis, and high short-term mortality. Primary percutaneous coronary intervention (PCI) has become the gold-standard reperfusion strategy for STEMI, effectively restoring epicardial blood flow, salvaging ischemic myocardium, and reducing in-hospital mortality ( 1 , 2 ). Despite guideline-directed medical therapy including dual antiplatelet…
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