Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
Association between Remnant Cholesterol and In-Stent Restenosis in Intracranial and Extracranial Vessels.
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Duan Minyu, Zhang Nan, Ma Shuyin, Zhang Xiaodong, Shi Kaili, Gao Tiantian, Yang Han, Ma Xiaodong, Cheng Yuxuan, Qu Huiyang, Fan Jiaxin, Yao Qingling, Zhan Shuqin
Аннотация
BACKGROUND: To explore the association between remnant cholesterol (RC) and intracranial and extracranial vascular in-stent restenosis (ISR).
METHODS: This prospective cohort study followed 392 patients who had undergone intracranial or extracranial vascular stent implantation from 2021 to 2022 over two years. The main outcome was the occurrence of ISR after stent placement. The association between RC levels and the occurrence of ISR was evaluated using a Cox hazards regression model, subgroup analysis, restricted cubic spline (RCS) plots and receiver operating characteristic (ROC) curve analysis.
RESULTS: The median follow-up for the 392 participants was 595 days, during which 80 ISR events occurred. The participants were divided into four groups based on the quartiles of RC levels. The cumulative incidence rates of ISR in quartiles Q1 to Q4 were 7.1 %, 14.6 %, 20.7 %, and 37.8 % (p < 0.001). Multivariate cox regression confirmed RC acts as an independent risk factor for intracranial vascular ISR but not extracranial vascular, the hazard ratios (HRs) with 95 % confidence intervals (CIs) for Q4 were 8.410 (3.239-21.831, p < 0.001). A linear dose-response relationship was observed between RC levels and ISR risk (p-non-linear = 0.660, p < 0.001).The predictive value of RC for intracranial vascular ISR is reflected by an area under curve (AUC) of 0.749 (95 % CI: 0.683-0.814, p < 0.001). The optimal cut-off level is 0.440 mmol/L, yielding a sensitivity of 71.4 %, specificity of 72.2 %, and a Youden index (YI) of 0.437.
CONCLUSIONS: RC level is an independent risk factor for intracranial vascular ISR.
METHODS: This prospective cohort study followed 392 patients who had undergone intracranial or extracranial vascular stent implantation from 2021 to 2022 over two years. The main outcome was the occurrence of ISR after stent placement. The association between RC levels and the occurrence of ISR was evaluated using a Cox hazards regression model, subgroup analysis, restricted cubic spline (RCS) plots and receiver operating characteristic (ROC) curve analysis.
RESULTS: The median follow-up for the 392 participants was 595 days, during which 80 ISR events occurred. The participants were divided into four groups based on the quartiles of RC levels. The cumulative incidence rates of ISR in quartiles Q1 to Q4 were 7.1 %, 14.6 %, 20.7 %, and 37.8 % (p < 0.001). Multivariate cox regression confirmed RC acts as an independent risk factor for intracranial vascular ISR but not extracranial vascular, the hazard ratios (HRs) with 95 % confidence intervals (CIs) for Q4 were 8.410 (3.239-21.831, p < 0.001). A linear dose-response relationship was observed between RC levels and ISR risk (p-non-linear = 0.660, p < 0.001).The predictive value of RC for intracranial vascular ISR is reflected by an area under curve (AUC) of 0.749 (95 % CI: 0.683-0.814, p < 0.001). The optimal cut-off level is 0.440 mmol/L, yielding a sensitivity of 71.4 %, specificity of 72.2 %, and a Youden index (YI) of 0.437.
CONCLUSIONS: RC level is an independent risk factor for intracranial vascular ISR.