Remnant Cholesterol as a Predictor of No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial...

Area of Science:

• Cardiology
• Biochemistry
• Clinical Medicine

Background:

• Remnant cholesterol (RC) is linked to atherosclerotic cardiovascular disease progression.
• The association between RC levels and no-reflow after primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) is not well understood.

Purpose of the Study:

• To investigate the impact of remnant cholesterol (RC) levels on the occurrence of the no-reflow phenomenon in STEMI patients undergoing pPCI.
• To identify independent predictors of no-reflow in this patient population.

Main Methods:

• Patients with STEMI undergoing pPCI were divided into no-reflow (+) (n=90) and no-reflow (-) (n=350) groups.
• Remnant cholesterol (RC) was calculated as Total Cholesterol - LDL-C - HDL-C.
• Multivariate logistic regression analysis was used to identify independent predictors of no-reflow.

Main Results:

• Remnant cholesterol (RC) was an independent predictor of no-reflow (Odds Ratio [OR]=1.28, P<.001).
• Other independent predictors included diabetes mellitus (OR=2.72, P=.002), stent length (OR=1.07, P=.020), door-to-balloon time (OR=1.04, P=.047), symptom-to-admission time (OR=2.07, P=.002), and presence of thrombus (OR=2.34, P<.001).
• RC demonstrated high predictive value for no-reflow development (Area Under the Curve [AUC]=0.923, P<.001).

Conclusions:

• A significant association exists between higher remnant cholesterol (RC) levels and the occurrence of no-reflow following pPCI in STEMI patients.
• RC assessment may aid in identifying STEMI patients at high risk for no-reflow.
• Managing RC levels could be an important strategy for improving cardiovascular health outcomes in STEMI patients.