Impact of small dense low-density lipoprotein cholesterol on cholesterol crystals in patients with acute coronary syndrome: An optical coherence tomography study

Sekimoto, Teruo; Koba, Shinji; Mori, Hiromu; Arai, Taito; Matsukawa, Naoki; Sakai, Rikuo; Yokota, Yuya; Sato, Sadayuki; Tanaka, Hideaki; Masaki, Ryota; Oishi, Yosuke; Ogura, Kunihiro; Arai, Ken; Nomura, Kosuke; Sakai, Koshiro; Tsujita, Hiroaki; Kondo, Seita; Tsukamoto, Shigeto; Matsumoto, Hidenari; Suzuki, Hiroshi; Shinke, Toshiro

doi:10.1016/j.jacl.2022.04.008

Cited by 9 publications

(3 citation statements)

References 36 publications

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“…Firstly, plaques rich in lipids are more prone to rupture, potentially leading to acute thrombotic events, which is of significant importance for risk assessment and treatment choices in ACS patients ( 12 ). Secondly, plaques rich in cholesterol crystals may be associated with inflammation, making them more prone to instability, which may require more intense anti-inflammatory treatment and closer monitoring ( 42 ). These differences underscore the need to consider not only the disease type but also the plaque morphology when treating patients with coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of optical flow ratio for cardiovascular outcomes in patients after percutaneous coronary stent implantation

Hu,

Qiu,

Xie

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThe relationship between the optical flow ratio (OFR) and clinical outcomes in patients with coronary artery disease (CAD) after percutaneous coronary stent implantation (PCI) remains unknown.ObjectiveTo examine the correlation between post-PCI OFR and clinical outcomes in patients with CAD following PCI.MethodsPatients who underwent optical coherence tomography (OCT) guided PCI at Guangdong Provincial People's Hospital were retrospectively and continuously enrolled. Clinical data, post-PCI OCT characteristics, and OFR measurements were collected and analyzed to identify predictors of target vessel failure (TVF) after PCI.ResultsAmong 354 enrolled patients, 26 suffered TVF during a median follow-up of 484 (IQR: 400–774) days. Post-PCI OFR was significantly lower in the TVF group than in the non-TVF group (0.89 vs. 0.93; P = 0.001). In multivariable Cox regression analysis, post-PCI OFR (HR per 0.1 increase: 0.60; 95% CI: 0.41–0.89; P = 0.011), large stent edge dissection (HR: 3.85; 95% CI: 1.51–9.84; P = 0.005) and thin-cap fibroatheroma (TCFA) (HR: 2.95; 95% CI: 1.19–7.35; P = 0.020) in the non-stented segment were independently associated with TVF. In addition, the inclusion of post-PCI OFR to baseline characteristics and post-PCI OCT findings improved the predictive power of the model to distinguish subsequent TVF after PCI (0.838 vs. 0.796; P = 0.028).ConclusionThe post-PCI OFR serves as an independent determinant of risk for TVF in individuals with CAD after PCI. The inclusion of post-PCI OFR assessments, alongside baseline characteristics and post-PCI OCT findings, substantially enhances the capacity to differentiate the subsequent manifestation of TVF in CAD patients following PCI.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of optical flow ratio for cardiovascular outcomes in patients after percutaneous coronary stent implantation

Hu,

Qiu,

Xie

et al. 2023

Front. Cardiovasc. Med.

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“…In addition, elevated TG levels are associated with lower HDL-C levels and the formation of small dense LDL particles [ 25 ]. A recent study on intracoronary imaging using optical coherence tomography revealed that high levels of small dense LDL-C are associated with the presence of vulnerable plaques [ 26 ]. The TG/HDL-C ratio is positively correlated with insulin resistance [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

The Association of Triglyceride to High-Density Lipoprotein Cholesterol Ratio with High-Risk Coronary Plaque Characteristics Determined by CT Angiography and Its Risk of Coronary Heart Disease

Koide

Miyoshi

Nishihara

et al. 2022

JCDD

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The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is an independent risk index for cardiovascular events. This study aimed to evaluate the association between TG/HDL-C ratio and coronary plaque characteristics as seen on coronary computed tomography angiography (CCTA) and the corresponding increase in the likelihood of cardiovascular events. A total of 935 patients who underwent CCTA for suspected coronary artery disease (CAD) were included. High-risk plaques (HRP) were defined based on three characteristics: positive remodeling, low-density plaques, and spotty calcification. Significant stenosis was defined as luminal narrowing of >70%. Patients with a higher TG/HDL-C ratio showed significantly greater prevalence of HRP and significant stenosis than patients with low TG/HDL-C ratios (p < 0.01). Multivariate logistic analysis demonstrated that the TG/HDL-C ratio was significantly associated with the presence of HRP (p < 0.01) but not with significant coronary stenosis (p = 0.24). During the median follow-up period of 4.1 years, 26 cardiovascular events including cardiovascular death and acute coronary syndrome occurred. The highest TG/HDL-C tertile was associated with cardiovascular events, with the lowest TG/HDL-C tertile as the reference (hazard ratio, 3.75; 95% confidence interval, 1.04–13.50). A high TG/HDL-C ratio is associated with the presence of CCTA-verified HRP, which can lead to cardiovascular events in patients with suspected CAD.

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“…The atherogenic risk of TG is related to the presence of high values of remnant-C, which plays a crucial role in atherogenesis and inflammation. TG-risk lipoproteins carry cholesterol and LDL-C, while higher TG and lower HDL-C levels lead to small LDL-C particles associated with vulnerable CAP formation [ 11 , 13 , 15 ]. Thus, screening and monitoring with CCTA using an advanced lipid profile can substantially help in risk stratification and the management of a high-risk patient population.…”

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confidence: 99%

The Roles of Coronary Computed Tomography Angiography in Characterizing Coronary Plaque: Screening, Treatment, and Prevention

Pour-Ghaz

Alkhatib

Isa

et al. 2023

JCDD

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Impact of small dense low-density lipoprotein cholesterol on cholesterol crystals in patients with acute coronary syndrome: An optical coherence tomography study

Cited by 9 publications

References 36 publications

Prognostic value of optical flow ratio for cardiovascular outcomes in patients after percutaneous coronary stent implantation

Prognostic value of optical flow ratio for cardiovascular outcomes in patients after percutaneous coronary stent implantation

The Association of Triglyceride to High-Density Lipoprotein Cholesterol Ratio with High-Risk Coronary Plaque Characteristics Determined by CT Angiography and Its Risk of Coronary Heart Disease

The Roles of Coronary Computed Tomography Angiography in Characterizing Coronary Plaque: Screening, Treatment, and Prevention

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