Remnant cholesterol but not LDL cholesterol is associated with 5-year bleeding following percutaneous coronary...

Area of Science:

• Cardiology
• Lipid Metabolism
• Clinical Research

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• Lipid management, particularly targeting low-density lipoprotein cholesterol (LDL-C), is crucial in cardiovascular disease prevention.
• The role of remnant cholesterol (RC) in long-term adverse events after PCI requires further investigation.

Purpose of the Study:

• To investigate the association between remnant cholesterol (RC) and low-density lipoprotein cholesterol (LDL-C) concentrations and the risk of long-term bleeding events.
• To explore the relationship between RC and LDL-C levels and the incidence of intracranial hemorrhage (ICH) post-PCI.

Main Methods:

• Prospective enrollment of 10,724 consecutive patients undergoing PCI in 2013.
• Median follow-up duration of 5.1 years.
• Recording of bleeding events and intracranial hemorrhages (ICH).

Main Results:

• Lower RC concentrations were independently associated with an increased risk of long-term bleeding events (HR: 0.47, 95% CI: 0.26-0.85).
• Lower LDL-C concentrations did not demonstrate a similar association with long-term bleeding risk.
• A significant non-linear relationship was observed between RC concentrations and the risk of ICH (P=0.014), but not for LDL-C.

Conclusions:

• Remnant cholesterol levels, not LDL-C, are significantly associated with an increased risk of long-term bleeding and ICH after PCI.
• These findings underscore the importance of considering RC in lipid management strategies for patients undergoing PCI.
• The results offer insights into the safety profile of LDL-C-lowering therapies in relation to bleeding risk.