Associations of lipid measures with total occlusion in patients with established coronary artery disease: a cross-sectional study

作者：Tianyu Li, Deshan Yuan, Peizhi Wang, Sida Jia, Ce Zhang, Pei Zhu, Ying Song, Xiaofang Tang, Xueyan Zhao, Zhan Gao, Yuejin Yang, Runlin Gao, Bo Xu, Jinqing Yuan · 发表于：Lipids in Health and Disease · 年份：2022 · DOI：10.1186/s12944-022-01733-8 · 被引用次数：29 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Coronary Interventions and Diagnostics、Lipoproteins and Cardiovascular Health

BACKGROUND: Total occlusion is the most severe coronary lesion, indicating heavy ischemic burden and poor prognosis. The lipid profile is central to the development of atherosclerotic coronary lesions. Evidence on the optimal lipid measure to be monitored and managed in patients with established coronary artery disease (CAD) is inconclusive. METHODS: Total cholesterol (TC), total triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), nonhigh-density lipoprotein cholesterol (non-HDL-c), lipoprotein (a) [Lp(a)], apolipoprotein B (apoB), non-HDL-c/HDL-c, and apoB/apoA-1 were analyzed in quintiles and as continuous variables. The associations of lipid measures with total occlusion were tested using logistic regression models, visualized with restricted cubic splines, and compared by areas under the receiver operating characteristic curves (AUROC). Discordance analysis was performed when apoB/apoA-1 and non-HDL-c/HDL-c were not in concordance. RESULTS: The prospective cohort study included 10,003 patients (mean age: 58 years; women: 22.96%), with 1879 patients having total occlusion. The risks of total occlusion significantly increased with quintiles of Lp(a), non-HDL-c/HDL-c, and apoB/apoA-1 (all p for trend < 0.001). TG had no association with total occlusion. Restricted cubic splines indicate significant positive linear relations between the two ratios and total occlusion [odds ratio per 1-standard deviation increase (95% confidence interval): non-HDL-c/HDL-c: 1.135 (1...