Li Liang

Xuzhou Medical University, China

Title: Influence of Remnant Lipoprotein Particle Cholesterol on Non-Target Lesions Progression In Patients Undergoing Percutaneous Coronary Intervention

---

Biography

Dr. Li Liang is a Chief Physician and a Master's supervisor at Xuzhou Medical University. Liang currently serves as the Deputy Director of the Cardiology Department, the Director of the Coronary Care Unit (CCU), the Director of the Heart Failure Center, and the Director of the Cardiovascular Metabolism Center. He is an editorial board member of Frontiers in Cardiovascular Medicine and a reviewer for the European Heart Journal. Liang specializes in the interventional treatment of coronary artery disease, bedside and intracardiac ultrasound, and the diagnosis and treatment of heart failure and critical cardiac conditions. He has long been engaged in basic and clinical research on coronary artery function and microcirculation assessment, and was the first in the world to propose the concept of using multiple quantitative indicators in MCE (Myocardial Contrast Echocardiography) for the combined evaluation of coronary blood flow.

Abstract

Background: The LDL-C is the primary lipid therapy target for coronary artery disease (CAD)a fter PCI. However, progression of coronary atherosclerosis occurs even LDL-C controlledw ell. This study aims to elucidate the relationship between RLP-C and the progression of nontarget lesions (NTLs) in patients with well-controlled lipid levels after PCI, as well as to exploret he clinical characteristics of patients with high RLP-C concentrations.

Methods: This retrospective study included 769 CAD patients who underwent percutaneousc oronary intervention (PCI) between May 1,2016, and May 31,2019, and followed up coronarya ngiography (CAG) within 6 to 24 months thereafter. LDL-C levels were used to assess lipidc ontrol. Patients were categorized into progression and non-progression groups based ont he assessment of NTLs progression via quantitative coronary angiography (QCA).

Multivariate Cox regression analysis identified RLP-C as an independent risk factor for NTLsp rogression. Using the ROC curve, an optimal cutoff value for RLP-C was determined, andp atients were stratified into two groups. Propensity score matching balanced confoundingf actors between groups, and Log-rank tests compared Kaplan–Meier curves for overallf ollow-up to assess NTLs progression.

Results: The control of LDL-C remains inadequate in CAD patients after PCI. Multivariate Coxa nalysis showed that RLP-C was an independent lipid risk factor for NTLs progression whenL DL-C controlled well. The ROC curve for RLP-C demonstrated an AUC of 0.721 (SE 0.044,9 5% CI=0.635–0.807, P<0.001), with an optimal cutoff of 0.555 mmol/L for predicting NTLsp rogression. Following propensity score matching, Kaplan–Meier curves illustrated as ignificantly higher cumulative rate of NTLs progression in patients with RLP-C levels ?0.555m mol/L (log-rank P<0.001; HR 4.175, 95% CI=3.045–5.723, P<0.001) compared to those with R LP-C levels <0.555 mmol/L. Elevated RLP-C levels were associated with high Triglyceride( TG) concentrations, diabetes mellitus (DM), and increased risk of revascularization.

Conclusion: The RLP-C could be a significant residual risk factor for cardiovascular diseasep rogression after PCI. Lowering RLP-C below 0.555 mmol/L may assist in mitigating thep rogression of NTLs.