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Background Evidence on the relationship between the low−/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and carotid plaques remains limited. This study aimed to examine the association between LDL-C/HDL-C and carotid plaques in participants with coronary heart disease (CHD) and to further explore the extent to which a healthy lifestyle reduces the risk of LDL-C/HDL-C-related carotid plaques. Methods This large-scale and multi-centre retrospective study included 9426 CHD patients (aged 35–75 years) between January 1, 2014 and September 30, 2020. The LDL-C/HDL-C values were converted to the following tertiles: lowest (< 2.15), middle (2.15–3), and highest (> 3). Healthy lifestyle-related factors referred to whether or not the participant was a non-smoker and non-drinker. Participants were divided into an unfavourable group (those who did not adhere to healthy lifestyle factors), intermediate (only one unhealthy factor), and favourable (neither of the two unhealthy factors). Logistic regression was used for statistical analyses. Results Of the 9426 participants, 6989 (74.15%) CHD patients had carotid plaques. After adjustment for confounders, each unit increase in the LDL-C/HDL-C was significantly associated with carotid plaques (OR: 1.61; 95%CI: 1.43–1.84; P <  0.001). Multivariate logistic regression revealed that carotid plaques risk for the highest tertile (> 3) was 1.18 times that of the lowest quartile (< 2.15). Compared with an unfavourable lifestyle, an intermediate or a favourable lifestyle was associated with a significant 30% (OR: 0.70; 95%CI: 0.64–0.78; P <  0.001) or 67% (OR: 0.33; 95%CI: 0.29–0.37; P <  0.001) reduction in carotid plaques risk, respectively, among CHD patients with high LDL-C/HDL-C. There were significantly additive and multiplicative interactions between lifestyle and LDL-C/HDL-C with regards to carotid plaques. Conclusion A high LDL-C/HDL-C is associated with a risk of carotid plaques developing in CHD patients. Adhering to a healthy lifestyle has additive beneficial effects on reducing the risk of carotid plaques, especially in relation to the highest LDL-C/HDL-C. Graphical abstract

Background:Patients with coronary heart disease (CHD) angina pectoris are in critical condition, which can cause sudden death, myocardial infarction, and other adverse events, and bring serious burden to families and society. Timely treatment should be given to improve the condition. Western medicine treatment of angina pectoris failed to meet the demand of angina symptom control.Objective:It is hoped that the research method with higher evidential value will be adopted to compare the short-term, medium-term, and long-term effects of Chinese patent medicine combined with conventional western medicine and conventional western medicine alone in the treatment of CHD angina pectoris, so as to tap the clinical efficacy advantages of traditional Chinese medicine (TCM) and provide reliable data support for its clinical application.Methods:A prospective cohort study was conducted among patients with CHD angina pectoris who were treated with oral Chinese patent medicine and conventional western medicine. The patients were divided into exposed group and nonexposed group according to whether or not the patients with CHD angina pectoris were treated with Chinese patent medicine. The exposed group was treated with TCM combined with conventional western medicine, while the nonexposed group was treated with conventional western medicine alone. Patients need to be hospitalized for 2 weeks as the introduction period and whether to enter the group is determined according to the treatment and medication conditions of the patients. The follow-up time points were 0th, 4th, 12th, 24th, and 48th weeks. The main events and secondary events were used as the evaluation criteria for clinical efficacy of CHD angina pectoris. In the experimental study, we will use strict indicators to detect standard operation procedure for multinomics and bacterial flora detection.Conclusion:This study will provide evidence for the clinical efficacy advantages of Chinese patent medicine and reliable support for its clinical application through test data.

Background: Coronary heart disease (CHD) is the leading cause of death globally. Angina pectoris is closely associated with coronary artery insufficiency, which seriously affects the quality of life and work of patients. Hypercholesterolemia and hypertension (HTN) are risk factors for CHD angina pectoris. The correlation between hypercholesterolemia with or without HTN and the severity of coronary arteries has not been clarified. Objective: To explore the correlation between hypercholesterolemia and the degree of coronary artery stenosis (CAS) of CHD angina pectoris, and to further research the influence of HTN on total cholesterol level and CAS, so as to provide guidance for clinical prevention and treatment. Methods: A multicenter, retrospective clinical study was conducted in the medical records management system of 6 hospitals in Tianjin. Patients who were suffered from CHD angina pectoris and aged from 35 to 75 years old are involved. They hospitalized in the Department of Cardiology between September 1, 2014, and September 1, 2019, and underwent coronary angiography. We divide patients into 3 groups based on the total cholesterol level, the degree of CAS is evaluated by Gensini score, and further divide them into 6 subgroups based on with or without HTN. Collect and analyze the demographics, laboratory information, clinical outcome data, and coronary angiographic data of patients. Conclusion: Through clinical research data, the study will help to provide guidance for the prevention and treatment of CHD angina pectoris complicated with diseases and promote further research.

Background: Evidence of the association the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) with the carotid plaques remains limited. The purpose of this study is to examine the association between LDL-C/HDL-C and carotid plaques of coronary heart disease (CHD), and to study what extent a healthy lifestyle reduces the risk of carotid plaques.Methods: In this large-scale and multi-center retrospective study, a total of 9,426 participants to explore the association between LDL-C/HDL-C and carotid plaques. No smoking and no drinking were considered healthy lifestyle. Generalised estimating equation models and conditional logistic regressions were used in statistical analyses.Results: In all the 9,426 participants, there were 6,989 (74.15%) patients having identified carotid plaques. High levels of LDL-C/HDL-C had a higher risk of carotid plaques than other lipid variables (OR:1.63; 95%CI:1.43-1.86). In stratified analyses by LDL-C/HDL-C triplet, participants in the LDL-C/HDL-C (＞3mmol/L) group had a higher risk of carotid plaques compared to other two groups. Compared with the unfavourable lifestyle, intermediate lifestyle or favourable lifestyle was associated with a significant 30% or 67% decrease in carotid plaques risk among patients with the LDL-C/HDL-C(＞3mmol/L) respectively. There were significantly additive and multiplicative interactions between lifestyle and LDL-C/HDL-C on carotid plaques.Conclusion: Our findings provide evidence that a high level of LDL-C/HDL-C can increase the risk of carotid plaques in patients with CHD. And adhering to a healthy lifestyle has additive beneficial effects on reducing the risk of carotid plaques.