The Effect of Total Cholesterol Variability on Clinical Outcomes After Percutaneous Coronary Intervention

Abstract

AimExploring the risk factors of prognosis in patients undergoing percutaneous coronary intervention (PCI) is of great importance. Our aim of the study is to investigate the association between variability in total cholesterol (TC) level and major adverse cardiovascular and cerebrovascular events (MACCE) in patients after PCI.MethodsBetween April 2004 and December 2009, 909 patients who underwent primary PCI and with at least three TC values were included in the final study. TC variability was calculated using four indices: standard deviation (SD), coefficient of variation (CV), the average successive variability (ASV), variability independent of the mean (VIM). MACCE comprised all-cause mortality, non-fatal myocardial infarction (MI), unplanned revascularization, hospitalization for heart failure, and non-fatal stroke.ResultsThere were 394 cases of MACCE during the follow-up period. When the subjects were divided into quartile groups by CV of TC, high CV groups were associated with a higher hazard ratio of MACCE than for lower CV groups. In multivariable adjusted models, TC variability and MACCE remained correlated [HR (95% CI): Q2, 1.17 (0.86–1.58); Q3, 1.38 (1.03–1.85); Q4, 1.63 (1.22–2.17)]. Similar patterns of MACCE were noted by quartiles of SD, ASV, and VIM.ConclusionVisit-to-visit TC variability is positively correlated with MACCE in patients after PCI.

Total Cholesterol Variability and the Risk of Osteoporotic Fractures: A Nationwide Population-Based Cohort Study

“…As is well known, TG, LDL-C, and HDL-C have different roles in the transport of cholesterol and different functions regarding atherogenesis and inflammation. Although the lack of detailed information on lipid fractions is one of the major limitations of this study, several previous studies have shown that total cholesterol variability is associated with the risk of vascular outcomes in patients after percutaneous coronary intervention, atrial fibrillation, end-stage renal disease, and dementia [ 15 , 18 , 43 , 44 , 45 ]. Second, the information about several medical conditions that can affect total cholesterol levels, including a history of familial hypercholesterolemia, and several well-known risk factors for osteoporotic fractures, including BMD values, vitamin-D levels, history of premature menopause, the use of medications such as glucocorticoids, and other endocrine or chronic inflammatory diseases, were not included in this study.…”

“…Intraindividual variability of several biological measures, including blood pressure, heart rate, and glucose, could be a predictive biomarker of adverse health outcomes [ 11 ]. Visit-to-visit cholesterol variability has been found to act as a risk factor for cardiovascular diseases, stroke, and mortality regardless of the cholesterol target levels achieved to lower the risk [ 12 , 13 , 14 , 15 , 16 ]. Moreover, cholesterol variability has been found to be related to a risk of end-stage renal disease, lower cognitive performance, and even Parkinson’s disease [ 17 , 18 , 19 ].…”

Effectivity of Sukamond Pudding as A Healthy Snack for Hypercholesterolemia Patients

“…The biggest risk factor for CAD is abnormal blood lipid metabolism. The risk is also greater with high total cholesterol concentration (Liang et al, 2022).…”