1. Small Dense Low-Density Lipoprotein Cholesterol: A Residual Risk for Rapid Progression of Non-Culprit Coronary Lesion in Patients with Acute Coronary Syndrome
- Author
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Ryota Masaki, Yuya Yokota, Yosuke Oishi, Ryota Kosaki, Taito Arai, Teruo Sekimoto, Koshiro Sakai, Ken Arai, Rikuo Sakai, Shinji Koba, Kosuke Nomura, Yuji Hamazaki, Shunya Sato, Fumiyoshi Tsunoda, Makoto Shoji, Kunihiro Ogura, Seita Kondo, Shigeto Tsukamoto, Hideaki Tanaka, Toshiro Shinke, Hiroaki Tsujita, Hiroyoshi Mori, and Hidenari Matsumoto
- Subjects
Male ,Acute coronary syndrome ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Culprit ,Triglyceride ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Myocardial infarction ,Stroke ,Small dense low-density lipoprotein cholesterol ,Aged ,business.industry ,Biochemistry (medical) ,Rapid progression ,Percutaneous coronary intervention ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Prognosis ,Coronary Vessels ,Stenosis ,Cardiology ,Apolipoprotein C3 ,lipids (amino acids, peptides, and proteins) ,Female ,Original Article ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Biomarkers ,Follow-Up Studies - Abstract
Aim: This study investigated whether the small dense low-density lipoprotein cholesterol (sd-LDL-c) level is associated with the rapid progression (RP) of non-culprit coronary artery lesions and cardiovascular events (CE) after acute coronary syndrome (ACS). Methods: In 142 consecutive patients with ACS who underwent primary percutaneous coronary intervention for the culprit lesion, the sd-LDL-c level was measured using a direct homogeneous assay on admission for ACS and at the 10-month follow-up coronary angiography. RP was defined as a progression of any pre-existing coronary stenosis and/or stenosis development in the initially normal coronary artery. CEs were defined as cardiac death, myocardial infarction, stroke, or coronary revascularization. Results: Patients were divided into two groups based on the presence ( n =29) or absence ( n =113) of RP after 10 months. The LDL-c and sd-LDL-c levels at baseline were equivalent in both the groups. However, the sd-LDL-c, triglyceride, remnant lipoprotein cholesterol (RL-c), and apoC3 levels at follow-up were significantly higher in the RP group than in the non-RP group. The optimal threshold values of sd-LDL-c, triglyceride, RL-c, and apoC3 for predicting RP according to receiver operating characteristics analysis were 20.9, 113, 5.5, and 9.7 mg/dL, respectively. Only the sd-LDL-c level (≥ 20.9 mg/dL) was significantly associated with incident CEs at 31±17 months (log-rank: 4.123, p =0.043). Conclusions: The sd-LDL-c level on treatment was significantly associated with RP of non-culprit lesions, resulting in CEs in ACS patients. On-treatment sd-LDL-c is a residual risk and aggressive reduction of sd-LDL-c might be needed to prevent CEs.
- Published
- 2021