ArticleCardiovascular diagnosis and therapy2025
Association between the ratio of high-density lipoprotein cholesterol to apolipoprotein A-I and in-stent neoatherosclerosis: an optical coherence tomography study.
Article in Cardiovascular diagnosis and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In-stent neoatherosclerosis (ISNA) is an important cause of in-stent restenosis (ISR) with drug-eluting stent (DES) implants. High-density lipoprotein cholesterol (HDL-C) is associated with ISNA. However, few studies have focused on the functionalities of HDL-C composition, and till date, optical coherence tomography (OCT) has not been used to analyze the relationship between ISNA incidence and HDL-C-to-apolipoprotein A-I ratio (HAR) in patients with DES implants and ISR (DES-ISR). This study aimed to clarify the association between HAR and ISNA. Methods: This single-center, retrospective study included patients admitted to the Affiliated Hospital of Zunyi Medical University. A total of 216 patients with 220 ISR lesions who underwent OCT for the culprit stent were included between July 2018 and November 2022. Based on HAR at admission, 33rd and 66th percentiles were identified as the cut-off points, and all eligible patients were divided into three groups: Tertile 1 (HAR ≤0.836; n=71), Tertile 2 (0.836< HAR <0.932; n=73), and Tertile 3 (HAR ≥0.932; n=72). Baseline characteristics and angiographic and OCT features were compared between the different groups. In addition, univariate and multivariate logistic regression models were used to assess the association of HAR with ISNA and in-stent thin-cap fibroatheroma (TCFA). Results: Angiographic characteristics and quantitative OCT assessment values did not differ significantly among the groups. The incidences of ISNA (62.0% Conclusions: OCT revealed high HAR levels to be negatively correlated with the incidences of ISNA and TCFA in patients with ISR. HAR is a better indicator of ISNA and plaque fragility than HDL-C itself, thus providing a marker and pathway for better prevention of ISNA.
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