Higher Serum Triglyceride Can Predict Recurrent Coronary Revascularization Events in Patients Undergoing Percutaneous Coronary Intervention With Baseline LDL-C<55mg/dl

Abstract Background: Patients with low baseline low-density lipoprotein cholesterol (LDL-C) but experiencing recurrent coronary revascularization events have been rarely investigated.Methods: In this retrospective study, we enrolled patients undergoing percutaneous coronary intervention (PCI) with baseline LDL-C <55mg/dl at the First Affiliated Hospital of Xi’an Jiaotong University between January and December 2017. Subsequent ischemia-driven revascularization events and all-cause death were documented during a 4-year follow-up. Cox analysis was used to evaluate the association between baseline clinical characteristics and long-term events. Results: Among 388 patients (mean age 63 years; 79.1% male) enrolled, 32 patients underwent recurrent revascularization events, and 38 patients occurred all-cause death. After adjustment for age, diabetes mellitus, multi-vessel disease and lipoprotein(a), multivariate Cox analysis showed that baseline serum triglyceride (TG) (HR=1.691, 95% CI: 1.178-2.428, p=0.004) was an independent predictor of recurrent coronary revascularization events. Kaplan-Meier analysis revealed that a higher TG level (≥1.17 mmol/L, determined by ROC curve) was associated with increased risk of recurrent revascularization events than lower TG level (<1.17 mmol/L) (p=0.021). Female (HR=2.647, 95%CI: 1.350-5.190, p=0.005) and previous atrial fibrillation (HR=3.163, 95%CI: 1.403-7.132, p=0.006) were associated with increased risk of all-cause death in this patient group. Conclusions: For patients undergoing PCI with baseline LDL-C <55mg/dl, higher baseline TG can predict recurrent coronary revascularization events.