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The Effect of Total Cholesterol Variability on Clinical Outcomes After Percutaneous Coronary Intervention

Yanting Liang1, Haochen Wang1, Fengyao Liu1

  • 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Frontiers in Public Health
|February 25, 2022
PubMed

Insights

High variability in total cholesterol (TC) levels after percutaneous coronary intervention (PCI) is linked to increased major adverse cardiovascular and cerebrovascular events (MACCE). This finding highlights TC variability as a potential risk factor for poor prognosis post-PCI.

Area of Science:

  • Cardiology
  • Clinical Research
  • Biostatistics

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for managing coronary artery disease.
  • Identifying prognostic risk factors after PCI is crucial for patient management and improving outcomes.
  • Total cholesterol (TC) levels are routinely monitored, but their variability may offer additional prognostic information.

Purpose of the Study:

  • To investigate the association between total cholesterol (TC) level variability and major adverse cardiovascular and cerebrovascular events (MACCE) in patients following PCI.
  • To determine if different measures of TC variability predict MACCE.
  • To assess TC variability as a potential risk factor for adverse outcomes after PCI.

Main Methods:

  • A cohort of 909 patients undergoing primary PCI with at least three TC measurements between April 2004 and December 2009 was analyzed.
  • TC variability was quantified using standard deviation (SD), coefficient of variation (CV), average successive variability (ASV), and variability independent of the mean (VIM).
  • MACCE included all-cause mortality, non-fatal myocardial infarction, unplanned revascularization, heart failure hospitalization, and non-fatal stroke.

Main Results:

  • A total of 394 MACCE cases were recorded during the follow-up period.
  • Higher quartiles of TC variability, particularly measured by CV, were associated with a significantly increased hazard ratio for MACCE.
  • Multivariable analysis confirmed a positive correlation between TC variability (across all four indices) and MACCE risk, with increasing risk observed in higher variability quartiles.

Conclusions:

  • Visit-to-visit variability in total cholesterol levels is positively correlated with the occurrence of major adverse cardiovascular and cerebrovascular events in patients after PCI.
  • TC variability emerges as a significant independent predictor of adverse outcomes in the post-PCI setting.
  • These findings suggest that monitoring and managing TC variability could be important for optimizing patient prognosis after PCI.
Abstract

Keywords:
cerebrovascular eventsclinical outcomescoronary artery diseasemajor adverse cardiovascularpercutaneous coronary interventiontotal cholesterol variability

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