Key result
Higher remnant cholesterol linked to ~28% greater no-reflow risk after primary PCI in STEMI.
Why the study?
The impact of remnant cholesterol levels on the occurrence of no-reflow in patients with STEMI undergoing primary PCI remains poorly understood.
Do remnant cholesterol levels predict the occurrence of the no-reflow phenomenon in patients with STEMI undergoing primary PCI?
Do remnant cholesterol levels predict the occurrence of the no-reflow phenomenon in patients with STEMI undergoing primary PCI?
Elevated remnant cholesterol is a strong, independent predictor of the no-reflow phenomenon in STEMI patients undergoing primary PCI, suggesting its utility in risk stratification.
Remnant cholesterol may aid no-reflow risk stratification in STEMI; leaves open causal role and need for prospective validation.
Remnant cholesterol (RC) has been implicated in the progression of atherosclerotic cardiovascular disease. However, the impact of RC levels on the occurrence of no-reflow in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI) remains poorly understood. Patients were classified into 2 groups: those (n = 90) who developed no-reflow (+) and those (n = 350) who did not develop no-reflow (−). RC was calculated as total cholesterol minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). RC (Odds Ratio [OR] = 1.28, P < .001), diabetes mellitus (OR = 2.72, P = .002), stent length (OR = 1.07, P = .020), door-to-balloon time (OR = 1.04, P = .047), symptom-to-admission time (OR = 2.07, P = .002) and presence of thrombus (OR = 2.34, P < 0.001) were independent predictors of no-reflow. RC was shown to predict no-reflow development (Area under the curve [AUC] = 0.923, P < .001). The present study revealed a significant association between RC levels and the occurrence of the no-reflow phenomenon following pPCI in patients with STEMI. Assessment of RC levels may assist in identifying high-risk groups in STEMI patients and may prove to be an important factor to manage for cardiovascular health.
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Dogan et al. (2025) studied this question. Higher remnant cholesterol levels were independently associated with increased risk of no-reflow in patients with STEMI after primary percutaneous coronary intervention (OR 1.28).
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