| Background and Purpose:Coronary heart disease(CHD)is coronary ischemic heart disease caused by coronary spasm or stenosis.There are many risk factors for its occurrence and development,among which dyslipidemia play an important role.Currently,serum low density lipoprotein cholesterol(LDL-C)is the primary intervention target for lipid management.However,recent studies have found that the risk of progression of atherosclerotic stenosis remains high despite lowering serum LDL-C levels,and that nontraditional lipid parameters and small dense low-density lipoprotein cholesterol(sd LDL-C)are more associated with cardiovascular events than serum LDL-C.Non-traditional lipids,including non-traditional lipid parameters and sd LDL-C.sd LDL-C is a small and dense subcomponent of LDL-C,while the traditional lipid parameters are new lipid parameters developed on the basis of traditional lipid parameters.Both of these two non-traditional lipids have advantages in predicting CHD,and their combined application in coronary artery stenosis is rarely studied.Therefore,this study aims to explore the relationship between non-traditional lipid parameters and sd LDL-C and coronary heart disease,so as to provide more sensitive lipid parameters for the prevention of coronary heart disease.Method:The study collected hospitalized patients who underwent coronary angiography(CAG)in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from August2021 to August 2022.According to the angiographic results,they were divided into two groups: CHD group and non-CHD group.Non-traditional lipid parameters were mainly calculated from total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and LDL-C,which mainly included nonhigh-density lipoprotein cholesterol(non-HDL-C),TC/HDL-C,LDL-C/HDL-C,and TG/HDL-C.General clinical data,blood biochemistry,coronary angiography results,and other indicators of inpatients in this study were collected.Chi-square test,nonparametric test,multivariate Logistic regression analysis and receiver operating characteristic curve(ROC)were used to evaluate the correlation between non-traditional lipid parameters and sd LDL-C and coronary heart disease.Results:1.A total of 188 patients receiving coronary angiography were included in this study,including 110 patients in the CHD group and 78 patients in the non-CHD group.The CHD group was older and more likely to be male than the non-CHD group.2.There were statistically significant differences in body mass index(BMI),hypertension,hyperlipidemia,smoking,and drinking history between CHD group and non-CHD group(P<0.05),but no statistically significant differences with cerebral infarction and type 2 diabetes history.3.When continuous variables of lipid parameters were included,univariate analysis showed that serum levels of TG,TC,LDL-C,non-HDL-C,LDL-C/HDL-C,TC/HDL-C,sd LDL-C,and TG/HDL-C in CHD group were higher than those in non-CHD group.The serum HDL-C level was lower than that of the nonCHD group,with statistical significance(P<0.05).4.After adjusting for gender,age,BMI,history of hypertension,hyperlipidemia,type 2 diabetes,alcohol use,smoking,and cerebral infarction,Multi-factor Logistics regression analysis showed that age,drinking history,hyperlipidemia,serum TG/HDL-C,LDL-C/HDL-C,sd LDL-C levels had statistical significance with the risk of coronary heart disease(P<0.05).5.Age,TG/HDL-C,LDL-C/HDL-C,sd LDL-C,drinking history,and hyperlipidemia were independent risk factors for coronary heart disease.6.Multi-factor Logistics regression analysis showed that serum TG/HDL-C(OR= 4.213,95%CI:1.106,37.996),LDL-C/HDL-C(OR= 3.773,95%CI: 1.702,8.360),and sd LDL-C(OR= 15.861,95%CI:1.144,219.854)were positively correlated with the risk of coronary heart disease.7.ROC curve indicated that the AUC of serum TG/HDL-C in non-traditional blood lipids was0.813(95%CI: 0.747,0.879,P<0.01),and that of serum LDL-C/HDL-C was 0.808(95%CI: 0.747,0.869,P<0.01),the AUC of serum sd LDL-C was 0.692(95%CI: 0.617,0.776,P<0.01),all of which had certain predictive power.Meanwhile,serum LDL-C AUC in traditional blood lipids was 0.750(95%CI: 0.680,0.820,P<0.01).However,the AUC increased to 0.847(95%CI: 0.793,0.902,P<0.01))when these non-traditional lipid parameters were combined with sd LDL-C.Conclusion:Serum TG/HDL-C,LDL-C/HDL-C,and sdLDL-C were independent risk factors for CHD,and were positively correlated with the occurrence of coronary heart disease.Compared with serum LDL-C,the combination of non-traditional lipid parameters and sd LDL-C is more sensitive and accurate,and has better predictive power for the occurrence of coronary heart disease. |
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