What type of study is this?

This is a Cross-Sectional Study study.

December 8, 2025Open Access

The association of non-HDL-C, NHHR, RC, and RCII with coronary artery stenosis severity in patients with acute coronary syndrome combined with cardiometabolic multimorbidity

GWGuoan WangQingdao University HDHongyan DaiQingdao University

Key Points

Severe coronary artery stenosis found in 50% of 298 patients with acute coronary syndrome and multimorbidity.
Non-HDL-C and other indices showed strong associations, with RCII having an OR of 2.78 for severe CAS.
Retrospective cross-sectional study utilized logistic regression and other analyses to gauge risk of coronary artery stenosis.
Findings highlight the need for targeted assessments of lipid indices in individuals with acute coronary syndrome and cardiovascular risks.

Abstract

Background Coronary heart disease, particularly acute coronary syndrome (ACS), is a significant public health concern, and its progression is expedited when combined with cardiometabolic multimorbidity (CMM). The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and remnant cholesterol inflammatory index (RCII) are novel lipid composite indices generated from non-high-density lipoprotein cholesterol (non-HDL-C) and remnant cholesterol (RC). This study examined the association between the aforementioned four indices and the degree of coronary artery stenosis (CAS) in individuals with ACS and CMM. Methods This retrospective cross-sectional study encompassed 298 patients diagnosed with ACS and CMM who underwent coronary angiography while hospitalized. Logistic regression models and restricted cubic spline analyses were used to investigate the association between non-HDL-C, NHHR, RC, and RCII with CAS. Two-stage logistic regression models were used to analyze threshold effects, while receiver operating characteristic analysis was conducted to test the predictive capability for severe CAS. Subgroup analyses were performed to evaluate risk among different demographic groups. Results Among the 298 participants, 150 (50.34%) had severe CAS. In multivariate logistic regression models, non-HDL-C, NHHR, RC, and RCII, when assessed per standard deviation, all exhibited a significant association with severe CAS. Among these, RCII had the strongest association with severe CAS (OR: 2.78, 95% CI 1.30-5.94), followed by NHHR (OR: 1.96, 95% CI 1.43-2.68). RCS analysis revealed a nonlinear relationship between RCII and severe CAS, with threshold effect analysis identifying an inflection point at 0.64. ROC analysis indicated that NHHR exhibited the greatest predictive capability, followed by RCII. The interaction test indicated no statistically significant difference in the association between the aforementioned four indices and CAS across subgroups. Conclusions Non-HDL-C, NHHR, RC, and RCII all showed a strong association with CAS in patients with ACS combined with CMM. RCII exhibited a nonlinear association with severe CAS, featuring an inflection point at 0.64.

Ask AI

Helpful

Bookmark

View Full Paper