Prognostic impact of residual inflammatory and triglyceride risk in statin-treated patients with well-controlled LDL cholesterol and atherosclerotic cardiovascular disease.

• Tác giả: Benjamin Bay, Deepak L Bhatt, George Dangas, Francesca Maria Di Muro, Yihan Feng, Mauro Gitto, Annapoorna Kini, Parasuram Krishnamoorthy, Prakash Krishnan, Pier Pasquale Leone, Roxana Mehran, Pedro Moreno, Johny Nicolas, Angelo Oliva, Samantha Sartori, Samin K Sharma, Kenneth Smith, Joseph Sweeny, Birgit Vogel
• Ngôn ngữ: eng
• Ký hiệu phân loại: 392.36088 Customs relating to dwelling places and domestic arts
• Thông tin xuất bản: England : European journal of preventive cardiology , 2025
• Bộ sưu tập: NCBI
• ID: 726128

Tóm tắt

 AIMS: Identifying alternative contributors to the residual risk of atherosclerotic cardiovascular disease (ASCVD) beyond LDL cholesterol (LDL-C) levels is crucial. We investigated the relative impact of triglycerides (TGs) and high-sensitivity C-reactive protein (hs-CRP) on outcomes in statin-treated patients with well-controlled LDL-C undergoing percutaneous coronary intervention (PCI) for established ASCVD. METHODS AND RESULTS: We included 9446 statin-treated patients with LDL-C <
  70 mg/dL undergoing PCI between 2012 and 2022, stratified into four groups: (i) no residual risk (TG <
 150 mg/dL + hs-CRP <
 2 mg/L)
  (ii) residual TG risk (TG ≥150 mg/dL + hs-CRP <
 2 mg/L)
  (iii) residual inflammatory risk (TG <
 150 mg/dL + hs-CRP ≥2 mg/L)
  and (iv) residual TG and inflammatory risk (TG ≥150 mg/dL + hs-CRP ≥2 mg/L). The primary endpoint was major adverse cardiovascular events (MACE) at 1 year, consisting of all-cause mortality, myocardial infarction, or stroke. Cox regression analysis was performed, using the no residual risk group as a reference. Of the total population, 5339 (56.5%) had no residual risk, 555 (5.9%) presented residual TG risk, 3009 (31.9%) had residual inflammatory risk, and 543 (5.7%) exhibited residual combined risk. After multivariable adjustment, patients with residual inflammatory or combined risk showed a significantly higher hazard of MACE, mainly driven by all-cause mortality. No significant difference was observed between patients with residual TG risk and those with no residual risk. CONCLUSION: In statin-treated patients with well-controlled LDL-C undergoing PCI, residual inflammatory risk-alone or in combination with residual TG risk-was associated with a higher incidence of MACE, highlighting the need for targeted preventive strategies beyond LDL-C lowering.