Remnant cholesterol but not LDL cholesterol is associated with 5-year bleeding following percutaneous coronary intervention

Jiawen Li; Yulong Li; Pei Zhu; Jingjing Xu; Xiaofang Tang; Shubin Qiao; Weixian Yang; Yuejin Yang; Runlin Gao; Jinqing Yuan; Xueyan Zhao

doi:10.1016/j.isci.2023.107666

Remnant cholesterol but not LDL cholesterol is associated with 5-year bleeding following percutaneous coronary intervention

iScience. 2023 Aug 19;26(10):107666. doi: 10.1016/j.isci.2023.107666. eCollection 2023 Oct 20.

Authors

Affiliation

¹ Department of Cardiology, Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Abstract

This study was aimed to investigate the association between remnant cholesterol (RC) and low-density lipoprotein cholesterol (LDL-C) concentrations and long-term bleeding. A total of 10,724 consecutive patients who underwent percutaneous coronary intervention in 2013 were prospectively enrolled. During a median follow-up of 5.1 years, 411 bleeding events and 42 intracranial hemorrhages (ICH) were recorded. The findings revealed that lower RC concentrations were independently associated with an increased risk of long-term bleeding events (continuous RC hazard ratio [HR]: 0.47, 95% confidence interval [CI]: 0.26-0.85; Q4 vs. Q1 HR: 0.66, 95% CI: 0.45-0.98), whereas lower LDL-C concentrations did not show a similar association. Additionally, a non-linear relationship was observed between RC concentrations and the risk of ICH (P for non-linear trend = 0.014), but no such relationship was found for LDL-C concentrations. These results provided insights into the safety of LDL-C-lowering therapy and emphasized the significance of RC concentrations in lipid management.

Keywords: Cardiovascular medicine; Molecular physiology; Pathophysiology; Public health.