Remnant Cholesterol to Lymphocyte Ratio as a New Predictor of Prognosis in Patients with Unstable Angina Undergoing Percutaneous Coronary Intervention

Hui Xi^1,†, Biyang Zhang^2,†, Tienan Sun², Jingrui Zhang^2,*, Haichen Lv^3,*

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¹ Peking University International Hospital, 102218 Beijing, China

² Beijing Anzhen Hospital affiliated Capital Medical University, 100089 Beijing, China

³ Cardiovascular Hospital of Dalian Medical University, The First Affiliated Hospital of Dalian Medical University, 116000 Dalian, Liaoning, China

^*Correspondence: im.zhangjr@foxmail.com (Jingrui Zhang); haichenlv@163.com (Haichen Lv)
^†These authors contributed equally.

Rev. Cardiovasc. Med. 2023, 24(3), 71; https://doi.org/10.31083/j.rcm2403071

Submitted: 31 May 2022 | Revised: 21 September 2022 | Accepted: 26 September 2022 | Published: 28 February 2023

This is an open access article under the CC BY 4.0 license.

Abstract

Background: Inflammatory cells and remnant cholesterol (RC) play an important role in the development and progression of cardiovascular diseases. In order to understand their contribution to cardiovascular diseases, we proposed the RC to lymphocyte ratio (RCLR) that reflects the level of serum lipid and inflammation as a predictive indicator. In this study, we explored the correlation between RCLR and major adverse cardiovascular events (MACEs) in patients with unstable angina (UA) treated with percutaneous coronary intervention (PCI). Methods: RCLR was calculated by dividing RC by lymphocyte percentage. Patients were divided into four groups according to RCLR quartiles. The endpoint of the study was MACE, a composite endpoint including all-cause mortality, non-fatal myocardial infarction (MI), and ischemia‑driven revascularization. The multivariable Cox proportional hazard model was used to determine the exclusive effect of RCLR on MACE. Results: The study was conducted on 1092 patients with UA. The rate of MACE increased as RCLR quartiles increased (quartile 4 vs quartile 1: 40.9% vs 9.2%, p $<$ 0.001). An adjustment for confounding variables revealed that an increase in the rate of MACE was directly proportional to RCLR (quartile 4 vs quartile 1: HR - 5.85 [95% CI, 3.77–9.08], p $<$ 0.001, p for trend $<$ 0.001). Conclusions: RCLR independently correlated with the incidence of MACE in patients with UA treated with PCI.