Correlation Between RC/HDL-C Ratio and Ct-Derived Fractional Flow Reserve in Coronary Heart Disease Patients with Critical Lesions

WU Zhen; SHUI Xing; WU Zhen; CHEN Zefeng; CHEN Lin

doi:10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2024.0314

您当前的位置：

首页 >

文章列表页 >

Correlation Between RC/HDL-C Ratio and Ct-Derived Fractional Flow Reserve in Coronary Heart Disease Patients with Critical Lesions

Clinical Research | 更新时间：2024-06-05

- Correlation Between RC/HDL-C Ratio and Ct-Derived Fractional Flow Reserve in Coronary Heart Disease Patients with Critical Lesions
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 45, Issue 3, Pages: 446-456(2024)
- 作者机构：
  
  中山大学附属第三医院心血管内科，广东广州 510630
- 作者简介：
  
  CHEN Lin；E-mail：cl1833@21cn.com
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2024.0314
  CLC： R698
- Published：20 May 2024，
  
  Received：05 February 2024，
  
  Accepted：24 April 2024
扫描看全文
吴祯,税星,吴震等.冠心病临界病变患者残余胆固醇/高密度脂蛋白胆固醇比值水平与冠脉CT血流储备分数的相关性[J].中山大学学报（医学科学版）,2024,45(03):446-456.

WU Zhen,SHUI Xing,WU Zhen,et al.Correlation Between RC/HDL-C Ratio and Ct-Derived Fractional Flow Reserve in Coronary Heart Disease Patients with Critical Lesions[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(03):446-456.
吴祯,税星,吴震等.冠心病临界病变患者残余胆固醇/高密度脂蛋白胆固醇比值水平与冠脉CT血流储备分数的相关性[J].中山大学学报（医学科学版）,2024,45(03):446-456. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2024.0314.

WU Zhen,SHUI Xing,WU Zhen,et al.Correlation Between RC/HDL-C Ratio and Ct-Derived Fractional Flow Reserve in Coronary Heart Disease Patients with Critical Lesions[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(03):446-456. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2024.0314.

摘要

目的

探讨冠状动脉粥样硬化性心脏病（冠心病）临界病变患者残余胆固醇/高密度脂蛋白胆固醇比值水平对冠脉CT血流储备分数（FFRct）的影响。

方法

本研究回顾性分析2022年1月1日-2022年12月31日中山大学附属第三医院心内科收治住院并行CCTA显示存在冠状动脉临界病变（管腔狭窄50%~70%）的219例患者为研究对象，其中临界病变血管304条。对以上纳入的冠脉临界病变血管行FFRct检查。FFRct以0.8为界，分为缺血组（FFRct≤0.8，

=108例）与非缺血组（FFRct＞0.8，

=111例）。采用多因素Logistic回归分析探究冠心病临界病变患者FFRct≤0.8的影响因素；绘制受试者工作特征（ROC）曲线评估RC/HDL-C对FFRct≤0.8的预测价值；并通过Pearson相关分析评估RC/HDL-C与FFRct之间是否存在相关性。

结果

缺血组中有糖尿病病史患者比例显著增高（

0.001）。与非缺血组相比，缺血组患者RC、RC/HDL-C比值、Non-HDL-C、APOB、HbA1c、FPG水平显著增高（

0.05）。Pearson相关性分析显示，RC/HDL-C比值、RC、Non-HDL-C、TC、TG、LDL-C、HDL-C、LP（a）、HbA1c、FPG

均与FFRct值呈显著负相关（

0.05）。单因素Logistic回归分析结果显示，糖尿病、RC、RC/HDL-C比值、Non-HDL-C、TG、LP（a）、HbA1c、FPG均与FFRct≤0.8均呈显著相关（

0.05）。多因素Logistic回归分析表明，RC/HDL-C比值是FFRct≤0.80的预测因子（OR=4.682，95%CI 1.197~18.316，

＜0.05）。

结论

冠状动脉粥样硬化性心脏病临界病变患者RC/HDL-C比值水平与FFRct≤0.8独立相关，RC/HDL-C比值可能成为评估冠状功能性缺血的潜在指标。

Abstract

Objective

To investigate the effect of remnant cholesterol （RC）/high-density lipoprotein cholesterol （HDL-C） ratio on coronary computed tomography-derived fractional flow reserve （FFRct） in coronary heart disease （CHD） patients with critical lesions.

Methods

A retrospective study was done on patients who were admitted to our department and underwent coronary computed tomography angiography （CCTA） from January 1， 2022 to December 31， 2022. All the 304 culprit vessels from the 219 patients with moderate coronary artery stenosis （50%~70%） were divided into FFRct ischemia group （FFRct≤0.8，

=108） and FFRct non-ischemia group （FFRct

0.8，

=111）. Multivariate logistic regression analysis was used to explore the influencing factors of FFRct≤0.8 in CHD patients with critical lesions. Receiver operating characteristic （ROC） curve was drawn to evaluate the predictive value of RC/HDL-C for FFRct≤0.8. Pearson correlation analysis was used to assess whether there was a correlation between RC/HDL-C and FFRct.

Results

There were significantly more diabetic patients in FFRct ischemia group （

0.001）. RC/HDL-C ratio， levels of RC， non-HDL-C， APOB， HbA1c and FPG in FFRct ischemic group were significantly increased （

0.05）. Pearson correlation analysis showed that the RC/HDL-C ratio， levels of RC， Non-HDL-C， TC， TG， LDL-C， HDL-C， LP（a）， HbA1c， and FPG were all significantly negatively correlated with FFRct values （

0.05）

. Univariate logistic regression analysis showed that diabetes mellitus， RC/HDL-C ratio， levels of RC， non-HDL-C， TG， LP（a）， HbA1c and FPG were significantly correlated with FFRct≤0.8 （

0.05）. Multivariate logistic regression analysis showed that RC/HDL-C ratio was a predictor of FFRct≤0.80 （OR=4.682， 95%CI 1.197~18.316，

0.05）.

Conclusions

RC/HDL-C ratio is independently correlated with FFRct≤0.8 in CHD patients with moderate stenosis and it is a potential indicator for evaluating coronary functional ischemia.

关键词

冠心病临界病变冠脉CT血流储备分数残余胆固醇/高密度脂蛋白胆固醇比值残余胆固醇脂代谢

Keywords

critical lesions of coronary heart diseasecomputed tomography-derived fractional flow reserve （FFRct）RC/HDL-C ratioremnant cholesterol （RC）lipid metabolism

references

Goeller M， Achenbach S， Cadet S， et al. Pericoronary adipose tissue computed tomography attenuation and high-risk plaque characteristics in acute coronary syndrome compared with stable coronary artery disease［J］. JAMA Cardiol， 2018， 3（9）： 858-863.

Goldberg IJ， Eckel RH， Mcpherson R. Triglycerides and heart disease： still a hypothesis？［J］. Arterioscler Thromb Vasc Biol， 2011， 31（8）： 1716-1725.

Liu L， Wen T， Zheng XY， et al. Remnant-like particles accelerate endothelial progenitor cells senescence and induce cellular dysfunction via an oxidative mechanism［J］. Atherosclerosis， 2009， 202（2）： 405-414.

Koo B-K， Erglis A， Doh J-H， et al. Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms［J］. J Am Coll Cardiol， 2011， 58（19）： 1989-1997.

Nørgaard BL， Leipsic J， Gaur S， et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease［J］. J Am Coll Cardiol， 2014， 63（12）： 1145-1155.

Authors/Task Force M， ESCCFPGuidelines， ESCNCSocieties. 2019 ESC/EAS guidelines for the management of dyslipidaemias： Lipid modification to reduce cardiovascular risk［J］. Atherosclerosis， 2019， 290： 140-205.

Castaner O， Pinto X， Subirana I， et al. Remnant cholesterol， not ldl cholesterol， is associated with incident cardiovascular disease［J］. J Am Coll Cardiol， 2020， 76（23）： 2712-2724.

Wadstrom BN， Pedersen KM， Wulff AB， et al. Elevated remnant cholesterol， plasma triglycerides， and cardiovascular and non-cardiovascular mortality［J］. Eur Heart J， 2023， 44（16）： 1432-1445.

Navarese EP， Vine D， Proctor S， et al. Independent causal effect of remnant cholesterol on atherosclerotic cardiovascular outcomes： a mendelian randomization study［J］. Arterioscler Thromb Vasc Biol， 2023， 43（9）： e373-e380.

Varbo A， Freiberg JJ， Nordestgaard BG. Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and all-cause mortality in 90000 individuals from the general population［J］. Clin Chem， 2015， 61（3）： 533-543.

Lupattelli G， Marchesi S， Lombardini R， et al. Mechanisms of high-density lipoprotein cholesterol effects on the endothelial function in hyperlipemia［J］. Metabolism， 2003， 52（9）： 1191-1195.

桂喜盈，田无忌，关俊文，等.脑创伤术后患者高密度脂蛋白胆固醇降低与深静脉血栓的关系［J］.四川大学学报（医学版），2020，51（1）：118-121.

Gui XY， Tian WJ， Guan JW， et al.Relationship between high-density lipoprotein cholesterol reduction and deep vein thrombosis in patients after cerebral trauma［J］.J Sichuan Univ （ Med Sci ），2020，51（1）：118-121.

Masuoka H， Ishikura K， Kamei S， et al. Predictive value of remnant-like particles cholesterol/high-density lipoprotein cholesterol ratio as a new indicator of coronary artery disease［J］. Am Heart J， 1998， 136（2）： 226-230.

王增武，刘静，李建军，等. 中国血脂管理指南（2023年）［J］. 中国循环杂志， 2023， 38（3）： 237-271.

Wang ZW， Liu J， Li JJ， et al.Chinese guidelines for lipid management （2023）［J］. Chin Circulat J， 2023， 38（3）： 237-271.

Varbo A， Benn M， Tybjaerg-Hansen A， et al. Remnant cholesterol as a causal risk factor for ischemic heart disease［J］. J Am Coll Cardiol， 2013， 61（4）： 427-436.

Von Eckardstein A， Nordestgaard BG， Remaley AT， et al. High-density lipoprotein revisited： biological functions and clinical relevance［J］. Eur Heart J， 2023， 44（16）： 1394-1407.

Yu D， Wang Z， Zhang X， et al. Remnant cholesterol and cardiovascular mortality in patients with type 2 diabetes and incident diabetic nephropathy［J］. J Clin Endocrinol Metab， 2021， 106（12）： 3546-3554.

Lin A， Nerlekar N， Rajagopalan A， et al. Remnant cholesterol and coronary atherosclerotic plaque burden assessed by computed tomography coronary angiography［J］. Atherosclerosis， 2019， 284： 24-30.

陈新杰，邓凌达，陈海雄，等.血清残余脂蛋白胆固醇浓度对冠状动脉易损斑块的诊断价值［J］.广东医学，2022，43（5）：597-602.

Chen XJ， Deng LD， Chen HX， et al. The diagnostic significance of serum residual lipoprotein cholesterol concentration for coronary artery vulnerable plaque［J］. Guangdong Med J， 2022， 43（5）： 597-602.

Nakajima K， Nakano T， Tanaka A. The oxidative modification hypothesis of atherosclerosis： the comparison of atherogenic effects on oxidized LDL and remnant lipoproteins in plasma［J］. Clin Chim Acta， 2006， 367（1-2）： 36-47.

Rader DJ， Hovingh GK. HDL and cardiovascular disease［J］. Lancet， 2014， 384（9943）： 618-625.

Tan M， Yang S， Xu X. High-density lipoprotein cholesterol and carcinogenesis［J］. Trends Endocrinol Metab， 2023， 34（5）： 303-313.

Verbeek R， Hovingh GK， Boekholdt SM. Non-high-density lipoprotein cholesterol： current status as cardiovascular marker［J］. Curr Opin Lipidol， 2015， 26（6）： 502-510.

Zou Y， Hu C， Kuang M， et al. Remnant cholesterol/high-density lipoprotein cholesterol ratio is a new powerful tool for identifying non-alcoholic fatty liver disease［J］. BMC Gastroenterol， 2022， 22（1）： 134.

Yang WS， Li R， Shen YQ， et al. Importance of lipid ratios for predicting intracranial atherosclerotic stenosis［J］. Lipids Health Dis， 2020， 19（1）： 160.

Zeng RX， Li S， Zhang MZ， et al. Remnant cholesterol predicts periprocedural myocardial injury following percutaneous coronary intervention in poorly-controlled type 2 diabetes［J］. J Cardiol， 2017， 70（2）： 113-120.

Hou C， Lu Y， Ma Y， et al. Investigation of the predictive value of a novel algorithm based on coronary CT angiography regarding fractional flow reserve and revascularization in patients with stable coronary artery disease［J］. Heart Vessels， 2024，39（3）：195-205.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Effect of Precocious Puberty on Glucose and Lipid Metabolism in Female Rats

Effects of Epstein-Barr Virus on Proliferation，Apoptosis and Lipid Metabolism of Gastric Cancer Cells

Related Author

CHEN Qiuli

DU Minlian

LI Yanhong

LIN Xiaoya

HUANG Baojiang

ZHANG Jun

GUO Song

MA Huamei

Related Institution

Department of Pediatrics， The First Affiliated Hospital of Sun Yat-sen University

Postal code：510080
Tel：020-87331643，87330827 Email：xbmed@mail.sysu.edu.cn
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰