Key result
Achieving optimal LDL-C reduction (<1.4 mmol/L and ≥50% reduction) was associated with a lower rate of non-target lesion plaque progression (OR 0.398; 95% CI 0.167-0.945; p=0.037).
Why the study?
Progression of NTLs after PCI causes future adverse cardiac events, but whether LDL-C reduction prevents this in a real-world setting had not been shown.
Does achieving optimal LDL-C reduction (LDL-C < 1.4 mmol/L and ≥50% reduction) prevent non-target lesion plaque progression in patients undergoing PCI?
Cohort (n=847)
Does achieving optimal LDL-C reduction (LDL-C < 1.4 mmol/L and ≥50% reduction) prevent non-target lesion plaque progression in patients undergoing PCI?
Odds Ratio: 0.398 (95% CI 0.167–0.945)
Absolute Event Rate: 11.11% vs 23.96%
p-value: p=0.037
Achieving guideline-recommended LDL-C levels (<1.4 mmol/L and ≥50% reduction) significantly reduces the risk of non-target lesion plaque progression after PCI.
May support stricter post-PCI LDL-C targets to limit non-target lesion progression; observational data leaves open randomized confirmation.
The progression of NTLs after PCI accounts for a significant portion of future adverse cardiac events. The reduction in LDL-C reduces cardiovascular events. This has, however, not yet been shown in a real-world setting. We aimed to investigate the association between LDL-C changes with progression in NTLs. A total of 847 patients with successful PCI were enrolled. Patients with follow-up LDL-C ≥ 1.4 mmol/L or percent reduction <50% compared to baseline were Non-optimal group (n = 793); patients with follow-up LDL-C < 1.4 mmol/L and percent reduction ≥50% compared to baseline were Optimal group (n = 54). Compared to Non-optimal group, Optimal group presented a lower rate of NTL plaque progression (11.11% vs. 23.96%; p = 0.007) and a lower follow-up TC (2.77 ± 0.59 vs. 3.66 ± 0.97; p < 0.001) and LDL-C (1.09 ± 0.26 vs. 2.03 ± 0.71; p < 0.001). The univariate logistic regression analysis revealed that follow-up LDL-C < 1.4 mmol/L and a percent reduction ≥50% from baseline was a protective factor for NTL plaque progression (OR: 0.397; 95%CI: 0.167–0.941; p = 0.036). The multivariate logistic regression model revealed that follow-up LDL-C < 1.4 mmol/L and percent reduction ≥50% was indeed an independent factor associated with a lower rate of plaque progression of NTLs (OR: 0.398; 95% CI: 0.167–0.945; p = 0.037). Therefore, achieving guideline-recommended LDL-C level was associated with a significantly reduced risk of NTL plaque progression.
No takes yet. Share an insight, caveat, or question.
Quan et al. (2023) conducted a cohort in Patients undergoing percutaneous coronary intervention (n=847). Optimal LDL-C reduction (follow-up LDL-C < 1.4 mmol/L and ≥50% reduction) vs. Non-optimal LDL-C reduction was evaluated on Non-target lesion plaque progression (OR 0.398, 95% CI 0.167-0.945, p=0.037). Achieving optimal LDL-C reduction (<1.4 mmol/L and ≥50% reduction) was associated with a lower rate of non-target lesion plaque progression (OR 0.398; 95% CI 0.167-0.945; p=0.037).