Differential lipid impact on mortality in patients undergoing CABG versus PCI

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Atherosclerosis Pub Date : 2025-02-17 DOI:10.1016/j.atherosclerosis.2025.119141

Xin Yuan , Lihua Zhang , Xi Li , Kai Chen , Qing Chu , Liang Chen , Shengshou Hu

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引用次数: 0

Abstract

Background and aims

The impact of revascularization type, including coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), on lipid control efficacy remains unclear. We aim to assess the associations of lipid levels with all-cause and cardiovascular mortality in patients undergoing PCI or CABG.

Methods

We used data from the ChinaHEART cohort and enrolled patients with a self-reported history of PCI or CABG. We employed Cox proportional hazards regression models to evaluate the associations between lipid levels and mortality.

Results

Our analysis included 29 003 participants, of whom 23 959 (82.6 %) undergoing PCI and 5044 (17.4 %) undergoing CABG. Over a median follow-up of 3.22 years, 1007 deaths were recorded, with 579 attributed to cardiovascular causes. Each 1 mmol/L increase in TC, LDL-C, and non-HDL-C was associated with multivariable-adjusted HRs of 1.16 (95 % CI 1.10,1.22), 1.23 (1.15,1.32) and 1.16 (1.10,1.23) for all-cause mortality, respectively. Similar results were observed in patients undergoing PCI, while no significant associations were found in patients undergoing CABG.

Conclusions

Elevated lipid levels are associated with all-cause and cardiovascular mortality in revascularization patients. Suboptimal lipid control appears to have a more pronounced effect on mortality in patients undergoing PCI. The effects of elevated lipid levels on mortality in CABG patients may need a longer follow-up to manifest due to the more complex nature of the grafts and the long-term adaptation process.

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.