Related Experiment Video
Updated: Jan 14, 2026
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Association of Remnant Cholesterol with Platelet Reactivity in Coronary Artery Disease Patients Receiving PCI
Menglu Liu1, Jiawen Li1, Kailun Yan1
1National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Remnant cholesterol (RC) levels are linked to altered platelet reactivity in patients receiving dual antiplatelet therapy after percutaneous coronary intervention (PCI). This suggests a connection between lipids and thrombosis, highlighting RC as a potential marker for monitoring PCI patients.
Area of Science:
- Cardiovascular Medicine
- Clinical Chemistry
- Thrombosis Research
Background:
- Remnant cholesterol (RC) is increasingly recognized for its association with clinical events, but underlying mechanisms require further elucidation.
- Understanding RC's role is crucial for managing cardiovascular disease (CVD) patients.
Purpose of the Study:
- To investigate the relationship between remnant cholesterol (RC) and platelet reactivity.
- To assess this association in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) on dual antiplatelet therapy (DAPT).
Main Methods:
- Analysis of 6,633 PCI patients from a larger cohort (n=10,724) in China.
- Utilized thrombelastography to assess on-treatment platelet reactivity, defining low (LTPR) and high (HTPR) platelet reactivity.
- Employed multivariate logistic regression to analyze the association between RC levels and platelet reactivity.
Main Results:
- Elevated RC levels were significantly associated with high on-treatment platelet reactivity (HTPR) (OR: 1.461) and low on-treatment platelet reactivity (LTPR) (OR: 0.761).
- Higher quartiles of RC showed a dose-dependent association with both HTPR and LTPR.
- These findings indicate a complex interaction between RC and platelet response to antiplatelet therapy.
Conclusions:
- Remnant cholesterol is associated with clopidogrel-related platelet reactivity in PCI patients on DAPT.
- Results suggest a significant interaction between lipid metabolism and thrombosis.
- RC may serve as a potential biomarker for platelet reactivity and associated risks in PCI patients.
Background:
Remnant cholesterol (RC) has received increasing attention and shown to be associated with bleeding and ischemic events in clinical research; however, the mechanisms remain incompletely understood.
Aim:
To investigate the relationship between RC and platelet reactivity in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) who received dual antiplatelet therapy with aspirin and clopidogrel.
Methods:
A total of 10,724 consecutive PCI patients in China from January 2013 to December 2013 were enrolled. 6,633 patients had the results of thromborlastogram for analysis. Low on-treatment platelet reactivity (LTPR) and high on-treatment platelet reactivity (HTPR) were defined as adenosine diphosphate-induced platelet maximum amplitude of thromborlastogram <31 mm and >47 mm, respectively.
Results:
A total of 6,633 PCI patients (mean age, 58.20 ± 10.2 years; male, 77.5%) were finally enrolled. When RC was used as a continuous variable, the multivariate logistic regression showed that RC concentration was negatively associated with LTPR (OR: 0.761, 95% CI 0.609-0.950) and positively associated with HTPR (OR: 1.461, 95% CI 1.151-1.855). For RC quartiles, compared to the lowest quartile (Q1), quartiles 3 and 4 were negatively associated with LTPR (ORQ3: 0.853, 95% CI 0.735-0.990; ORQ4: 0.840, 95% CI 0.707-0.999). Meanwhile, higher quartiles of RC (Q2, Q3, Q4) were positively associated with HTPR (ORQ2: 1.193, 95% CI 1.015-1.402; ORQ3: 1.356, 95% CI 1.152-1.596; ORQ4: 1.404, 95% CI 1.164-1.694).
Conclusions:
We reported that RC was associated with clopidogrel-related platelet reactivity in patients undergoing PCI received dual antiplatelet therapy. These results suggest an interaction between lipid and thrombosis, and remind us pay attention to RC levels in PCI patients.
Key Findings:
In the large-scale (n = 6,633) and real-world study, we revealed that RC may modify the platelet reactivity to influence the risk of bleeding and ischemia in PCI patients. Our study firstly reported the relationship between RC and clopidogrel-related platelet reactivity in patients undergoing PCI received dual antiplatelet therapy. The findings may verify the complex interaction between lipid and thrombosis and suggest that RC may be a potential marker associated with platelet reactivity, which warrants further investigation in future studies.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:26Coronary Artery Disease II: Pathophysiology
01:26Coronary Artery Disease IV: Preventive Measures
01:27Peripheral Artery Disease III: Interprofessional Care
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT