Remnant Cholesterol to Lymphocyte Ratio as a New Predictor of Prognosis in Patients with Unstable Angina Undergoing Percutaneous Coronary Intervention

TL;DR

This study introduces a new predictor of poor outcomes in unstable angina patients undergoing heart procedures, based on a ratio of cholesterol and lymphocyte levels.

Contribution

The RC to lymphocyte ratio (RCLR) is proposed as a novel prognostic indicator for cardiovascular events in unstable angina patients.

Findings

Higher RCLR quartiles were strongly associated with increased major adverse cardiovascular events (MACE).

The highest RCLR quartile had a 5.85-fold increased risk of MACE compared to the lowest quartile.

RCLR independently predicted MACE after adjusting for confounding factors.

Abstract

Inflammatory cells and remnant cholesterol (RC) play an
important role in the development and progression of cardiovascular diseases. In
order to understand their contribution to cardiovascular diseases, we proposed
the RC to lymphocyte ratio (RCLR) that reflects the level of serum lipid and
inflammation as a predictive indicator. In this study, we explored the
correlation between RCLR and major adverse cardiovascular events (MACEs) in
patients with unstable angina (UA) treated with percutaneous coronary
intervention (PCI).

RCLR was calculated by dividing RC by
lymphocyte percentage. Patients were divided into four groups according to RCLR
quartiles. The endpoint of the study was MACE, a composite endpoint including
all-cause mortality, non-fatal myocardial infarction (MI), and ischemia‑driven
revascularization. The multivariable Cox proportional hazard model was used to
determine the exclusive effect of RCLR on MACE.

The study was
conducted on 1092 patients with UA. The rate of MACE increased as RCLR quartiles
increased (quartile 4 vs quartile 1: 40.9% vs 9.2%, p < 0.001). An
adjustment for confounding variables revealed that an increase in the rate of
MACE was directly proportional to RCLR (quartile 4 vs quartile 1: HR - 5.85 [95%
CI, 3.77–9.08], p < 0.001, p for trend < 0.001).

RCLR independently correlated with the incidence of MACE in
patients with UA treated with PCI.

Figures