Relationship Between LDL-C/HDL-C Ratio And Prognosis Of Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention

Objective: In order to study the ratio of low-density lipoprotein cholesterol(LDL-C)/ high-density lipoprotein cholesterol(HDL-C)and it’s relationship with the prognosis of patients with acute coronary syndromes(ACS)treated by Percutaneous Coronary Intervention(PCI).Provide relevant theoretical and practical support for the clinical lipid-lowering therapy research of ACS patients and improve the prognosis of their diseases.Method: Screening 357 patients with ACS who were hospitalized in the First Affiliated Hospital of Guangxi Medical University from March 2017 to March 2019 and met the inclusion criteria for this study.Using standard methods to measure their blood biochemical indicators and calculate the LDL-C/HDL-C ratio,According to the median LDL-C/HDL-C ratio,Patients with less than the median of LDL-C/ HDL-C ratio were divided into low LDL-C/HDL-C ratio groups,and those with greater than LDL-C/HDL-C ratio were divided into high LDL-C /HDL-C ratio group,follow-up and comparison of the occurrence of major adverse cardiovascular events within 1 year after interventional treatment of the two groups of ACS patients.Collect demographic data,past history,smoking history,drinking history,medication status,systolic blood pressure and other general data of all patients and hemoglobin(HB),platelets(PLT),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and other biochemical indicators.Compare the general information and biochemical indexes of the two groups of patients.Binary Logstic regression equation was used to analyze the relationship between LDL-C/HDL-C ratio and clinical prognosis;Draw receiver operating characteristic(ROC)curve to evaluate the sensitivity and specificity of LDL-C/HDL-C to predict MACE.Results: The study included 357 patients after screening,including 287 male patients and 70 female patients.The mean age was 63.28±10.67 years.The high ratio group contains 180 patients,and the low ratio group contains 177 patients.The statistical data results are analyzed as follows:(1).Comparison of the general clinical data of the two selected patients shows: age,male ratio,admission blood pressure,smoking history,the history of drinking,high blood pressure,diabetes,number of coronary artery lesions,and the ratio of aspirin,clopidogrel or ticagrelor,ACEI/ARB,β-blockers,and statins after operation have no significant difference(P>0.05).(2).Comparison of biochemical indicators and cardiac ultrasound examination results: the two groups of patients had no statistically significant difference in indicators such as hemoglobin,platelets,and left ventricular ejection fraction(P>0.05).However,the plasma lipid concentration(TC,TG,LDL-C,HDL-C)was significantly different between the two groups of subjects(P<0.05).(3).The results of a follow-up study of major adverse cardiac events(MACE)in two groups of subjects during the 1-year follow-up period after interventional therapy shows: According to the LDL-C/HDL-C ratio,the cardiovascular death of ACS patients grouped within 1year after percutaneous coronary intervention was not statistically significant(P>0.05).There was a statistically significant difference between the two groups in the cumulative incidence of target lesion revascularization(TLR)and the overall incidence of MACE(P<0.05).Comparing the two groups of patients,the incidence of target lesion revascularization and overall MACE in the high ratio group was significantly higher than that in the low ratio group.(4).Logistic regression analysis of the two selected patients can be seen: gender(coefficient B: 1.079,OR: 2.941,95% CI: 1.247 ～ 6.934,P <0.05)and LDL-C/HDL-C(coefficient B: 0.293,OR: 1.340,95 % CI: 1.006 ～ 1.785,P<0.05)is an independent risk factor for MACE in long-term follow-up of ACS patients.(5).ROC curve analysis showed that: The optimal cut-off point for LDL-C/HDL-C level to predict adverse cardiovascular events after coronary intervention in ACS patients is 2.765mmol/L,and its sensitivity for predicting adverse cardiovascular events after coronary intervention in ACS patients is69.8%,specificity was 46.4%,area under the curve(AUC)was 0.574(P<0.05,95%CI 0.521～0.626).Conclusion: LDL-C/HDL-C ratio is an independent risk factor for major adverse cardiovascular events during the 1-year follow-up of coronary stent implantation in patients with ACS.Intensive statin therapy in patients with an increased LDL-C/HDL-C ratio may help reduce the occurrence of adverse cardiovascular events and improve their clinical prognosis.