ArticleReviews in cardiovascular medicine2025
Residual Inflammatory and Cholesterol Risk and the Association With Recurrent Cardiovascular Events in East Asian Patients After Percutaneous Coronary Intervention.
Article in Reviews in cardiovascular medicine, 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: The applicability of currently established high-risk inflammatory criteria to East Asian patients is unknown, particularly concerning the hypersensitive C-reactive protein (hs-CRP) cutoff value. In addition, the role of cholesterol and inflammation in determining the prognosis of these patients might shift after the patient accepts lipid-lowering treatments. This study aimed to explore the high-risk hs-CRP cutoff value and compare the prognostic value between inflammation and cholesterol risk in the East Asian population after treatment with percutaneous coronary intervention (PCI). Methods: Post-PCI patients with serial hs-CRP and low-density lipoprotein cholesterol (LDL-C) level measurements were retrospectively enrolled. Major adverse cardiovascular and cerebrovascular events (MACCEs) were defined as a composite of cardiovascular death, non-fatal acute myocardial infarction (AMI), non-fatal stroke, and unplanned coronary revascularization. The association between residual risks and MACCEs was evaluated. Results: During a median follow-up of 30.4 months, 403 MACCEs occurred among 2373 patients. The high-risk LDL-C and hs-CRP cutoff values in the present study were set at 1.56 mg/L and 1.80 mmol/L, respectively, based on the results of tertile stratification and restricted cubic spline analysis. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of residual cholesterol risk (hs-CRP <1.56 mg/L; LDL-C ≥1.80 mmol/L), residual inflammatory risk (hs-CRP ≥1.56 mg/L; LDL-C <1.80 mmol/L), and residual cholesterol and inflammatory risk (hs-CRP ≥1.56 mg/L; LDL-C ≥1.80 mmol/L) for MACCEs were 1.26 (0.95-1.66), 2.15 (1.57-2.93), and 2.07 (1.55-2.76), respectively. Inflammatory-induced MACCEs were more likely to be associated with the increased risk of non-fatal AMI (HR: 4.48; 95% CI: 2.07-9.73; Conclusions: Despite statin treatment, residual cholesterol and inflammatory risks persist in post-PCI patients. The high-risk hs-CRP standard may be lower in East Asian patients than their Western counterparts, with a cutoff value of 1.56 mg/L. Inflammation and cholesterol could be major determinants for recurrent cardiovascular events, while hs-CRP seems to be a stronger predictor than LDL-C in post-PCI patients receiving statin therapy. Clinical Trial Registration: ChiCTR2100047090, https://www.chictr.org.cn/showproj.html?proj=127821.
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