Effect Of LDL-C Level On Changes Of SYNTAX And SYNTAX Score Ⅱ In Patients With Coronary Artery Disease After PCI

ObjectiveTo investigate the effect of low-density lipoprotein cholesterol(LDL-C)level on changes of SYNTAX and SYNTAX score Ⅱ in patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Methods150 patients with CAD who receiving PCI therapy from October 2017 to December2019 in Wujin Hospital Affiliated to Jiangsu University were selected randomly.Coronary angiography(CAG)was reviewed after 10-15 months after adjusting the lipid-lowering drugs based on LDL-C levels.The SYNTAX and SYNTAX score Ⅱ of all selected patients were calculated after PCI and at the time of reviewing CAG respectively.The relevant baseline characteristics were recorded.According to LDL-C levels during CAG,patients were divided into low LDL-C level group(LDL-C≤1.4mmol/L),non-low LDL-C level group(1.4≤LDL-C<1.8 mmol/L),and substandard LDL-C level group(LDL-C≥1.8 mmol/L).Statistical difference of changes of SYNTAX score(value of score after PCI subtracting score of reviewing CAG)and changes of SYNTAX score Ⅱ among the three groups were compared.Patients were divided into improvement group(ΔSYNTAX score>0),maintenance group(ΔSYNTAX score=0)and deterioration group(ΔSYNTAX score<0)according to changes in SYNTAX score.Patients were divided into improvement group(ΔSYNTAX Score Ⅱ≥0),mild deterioration group(-2.6≤ΔSYNTAX Score Ⅱ<0),and significant deterioration group(ΔSYNTAX Score Ⅱ<-2.6)according to changes in SYNTAX Ⅱ score.Multivariate logistic regression analysis is used to explore potential risk factors of changes of SYNTAX score and SYNTAX score Ⅱ.ResultsThe ΔSYNTAX score and ΔSYNTAX score Ⅱ of the low LDL-C level group are higher than those of the substandard LDL-C level group(P=0.015,P=0.034).TheΔSYNTAX score Ⅱ of the non-low LDL-C level group is higher than that of the substandard LDL-C level group(P=0.038).No statistically significant difference can be found in gender,age,infection index,liver and kidney function,coagulation function and glycated hemoglobin among low LDL-C level group,non-low LDL-C level group and substandard LDL-C level group(P>0.05).Multivariate logistic regression analysis shows that compared with the improvement group according to ΔSYNTAX score,the OR value of low-density lipoprotein cholesterol(LDL-C)in the deterioration group is11.259,95%CI 1.563-81.125(P=0.016),and the OR value in the maintenance group is7.039,95%CI 1.040-47.649(P=0.046);compared with the significantly deterioration group according to ΔSYNTAX score Ⅱ,the OR value of LDL-C in the improving group is 0.109,95%CI 0.014-0.862(P=0.036).No statistical significance can be found in the remaining baseline features.ConclusionLDL-C is an independent risk factor to changes of SYNTAX score and SYNTAX score Ⅱ in patients with CAD,and low LDL-C level can further delay lesions progression in patients with CAD after PCI compared with non-low LDL-C level.