Correlation Between Progression Of Non-target Coronary Lesions And Non-HDL-C And HDL-C In Patients After Selective Percutaneous Coronary Intervention

BackgroundAlthough percutaneous coronary intervention(PCI)has a significant effect on the treatment of coronary heart disease(CHD),it still faces the problems of in-stent restenosis of target lesions and non-target lesions progression.Objective1.To explore the relationship between the progression of non-target coronary lesions and the dynamic changes of non-HDL-C and HDL-C in patients with CHD after elective PCI.2.To evaluate the diagnostic and predictive value of non-HDL-C dynamic change in the progression of coronary non-target lesions.Methods1.From January 2017 to May 2019,150 patients with CHD who were readmitted after elective PCI in the department of Cardiology Medicine of Xijing Hospital were selected and divided into two groups: the Progressive Group(45 cases)and the non-progressive group(105 cases).2.Compare the age,sex,history of hypertension,smoking history,history of diabetes,nationality(including Hui and Han),family history of CHD,body mass index(BMI,BMI= weight / height~2),follow-up time(2nd admission time-1st admission time),SYNTAX Score,1st and 2nd admission lipid profile [including TC,non-HDL-C(non-HDL-C = TCHDL-C),TG,TG / HDL-C,HDL-C,non-HDL-C / HDL-C,and LDL-C].3.Multiple Logistic regression analysis was used to analyze the influencing factors of non-target lesions progression in patients with CHD after elective PCI.The ROC curve was drawn with MedCalc statistical software to evaluate the predictive value of non-HDLC on the progression of non-target lesions in patients with CHD after elective PCI.Results1.General information of the study subjects: The average age of patients enrolled was57.92 ± 11.28 years,including 118 males(78.7%),average age 56.11 ± 11.34 years,32females(21.3%),average age 60.97 ± 10.15 years;144 Hans(96%),Hui 6 cases(4%);62smokers(41.3%);38 cases of diabetes(25.3%);63 cases of hypertension(42%);4 cases of family history of coronary heart disease(4.2%).The lipid-lowering drugs used in all patients were statins,mainly atorvastatin and rosuvastatin.2.Single-factor analysis of data between the two groups: According to the progress of non-target lesions,the selected subjects were divided into non-target lesions progression group and non-progression group,of which 45 cases(30%)were in the progress group and105 cases were in the non-progression group(70%).Age,ethnicity,smoking rate,incidence of hypertension,family history of CHD,follow-up time,BMI,the first admission HDL-C,LDL-C,TG / HDL-C,non-HDL-C / HDL-C,the second admission HDL-C,TC,TG,LDLC,non-HDL-C,TG / HDL-C,non-HDL-C / HDL-C,and the two admission HDL-C difference was not statistically significant between the two groups(P> 0.05).The proportion of women in the progression group,the incidence of diabetes,and the SYNTAX Score were higher than those in the non-progression group,and the difference of TC,TG,LDL-C,nonHDL-C,TG / HDL-C,non-HDL-C / HDL-C was higher than that in the non-progressive group,and the difference was statistically significant(P < 0.05).3.Multivariate Logistic Regression Analysis of Factors Affecting the Progression of Non-Target Lesions: Binary Logistic regression analysis was performed on gender,history of diabetes,TC,TG,LDL-C,non-HDL-C,TG / HDL-C,and non-HDL-C / HDL-C.The results showed that non-HDL-C,TG / HDL-C,history of diabetes,and gender were risk factors for progression of non-target lesions in patients with CHD after elective PCI(P<0.05).The OR value of non-HDL-C is 2.089,95% confidence interval is 1.189 ～ 3.671;OR value of TG / HDL-C is 1.494,95% confidence interval is 1.031 ～ 2.164;OR value of diabetes history is 2.946,The 95% confidence interval is 1.222 ～ 7.102;the OR value of gender is 0.302,and the 95% confidence interval is 0.122 ～ 0.751.4.Evaluation of the predictive value of non-HDL-C and TG / HDL-C in the diagnosis of non-target lesions progression: ROC curve was plotted using MedCalc statistical software to evaluate the predictive value of non-HDL-C and TG / HDL-C dynamic changes on the progression of non-target lesions in patients with CHD after elective PCI.The area under the non-HDL-C curve(AUC)is 0.701 [95%CI(0.603,0.800)],P <0.05;the area under the TG / HDL-C curve is 0.657 [95%CI(0.559,0.755)],P <0.05;there is no significant difference in the area under the curve(Z = 0.76),P = 0.447).Conclusion1.The dynamic change of non-HDL-C is independent risk factor for the progression of coronary non-target lesions in patients with CHD after elective PCI.2.The dynamic change of non-HDL-C has predictive value for the progression of nontarget lesions.3.In patients with CHD after elective PCI,the risk of non-target coronary disease progression is still present even if HDL-C level is within the normal reference range.